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Query: UMLS:C0004093 (asthenia)
 2,650 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cachexia is the most common paraneoplastic syndrome of malignancy and is characterized by anorexia, early satiety, severe body compositional change with weight loss, adipose and muscle loss, weakness (asthenia), anemia, and edema. Cause of death in as many as 20% of patients with cancer is associated with tumor-induced and treatment-related malnutrition and inanition. Early diagnosis of cancer malnutrition often is missed because of lack of attention by the oncology team. The importance of understanding the basics of nutritional oncology by the entire healthcare team (physician, nurse, pharmacist, dietitian, social worker, physical and speech therapists) and the patient and family is outlined with practical interventions being specified. An algorithm for an optimal nutritional approach in patients with cancer is included, with emphasis on early diagnosis and intervention for maintenance of nutritional, body compositional, and functional status of the oncology patients. Quality-of-life issues, pharmacologic intervention in cachexia, and necessity of cooperative oncology group involvement in nutritional oncology are discussed.
Cancer Pract
PMID:Cancer cachexia: prevention, early diagnosis, and management. 805 14

A 44-year old woman was referred because of metrorrhagia and asthenia. A diagnosis of uterine malignancy was suspected on the basis of the management of the Cervix uteri and an elevated erythrocyte sedimentation rate. Conisation and hysterectomy were performed, and histological examination revealed necrotising vasculitis affecting the Cervix uteri. Corpus uteri, muscle and fat biopsies showed no Periarteritis nodosa lesions. The incidental finding of necrotising arteritis in a surgical uterine specimen, involves further study to exclude systemic disease. The ability to involve any organ in the body makes it possible for specialists in every branch of medicine to be involved in the management and care of these patients.
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PMID:[Diagnosis of local panarteritis nodosa of the uterine cervix]. 810 52

Asthenia is a very common symptom of patients with advanced cancer, but its investigation is hindered by a lack of suitable validated measuring instruments. The goal of the present study was to construct and validate a questionnaire for the study of asthenia in cancer patients, as well as to establish correlations with other symptoms and physiological and biochemical parameters. A group of 31 patients with advanced cancer and a control group of 30 healthy volunteers were examined. The proposed questionnaire, based on visual analogue scales, questions with categorical answers and on the hospital anxiety and depression scale was validated by comparing results of the patient and control groups, by the test/retest method and by comparison with the evaluation of an observer. Correlation with various physiological and biochemical parameters was performed. The questionnaire distinguished well among the patients and control groups. VAS of asthenia proved quite stable over a period of 5 days. Correlations of asthenia with lack of appetite, the hospital anxiety and depression scale, weight, heart rate and serum cortisol levels could be established. No significant correlation between asthenia and various serum markers of inflammation and cytokines, including C-reactive protein, tumour necrosis factor, interleukin-1, and interleukin-2 receptors, could be found. The proposed questionnaire for evaluation of asthenia could be validated in a patient sample of limited size and a simplified questionnaire based on visual analogue scales is being developed for further investigations.
Support Care Cancer 1993 Mar
PMID:Preliminary results of a study assessing asthenia and related psychological and biological phenomena in patients with advanced cancer. 814 2

The concomitant generation of macrophage-mediated suppressive events, as documented by the increase in neopterin and soluble interleukin-2 (IL-2) receptor (SIL-2R), and the enhanced production of cortisol, would represent the most investigated phenomena responsible for the reduced anticancer efficacy of IL-2 immunotherapy in humans. Based on our preliminary experimental studies suggesting a modulatory role of IL-3 on immune and endocrine effects induced by IL-2, a study was performed to evaluate the influence of IL-3 on biological effects of IL-2 cancer immunotherapy. We have evaluated 12 immunotherapeutic courses with IL-3 plus IL-2, which were performed in 6 patients with metastatic non-small cell lung cancer. The results were compared to those seen in 22 courses with IL-2 alone, carried out in 12 patients with metastatic non-small cell lung cancer. IL-3 was given intravenously at a daily dose of 1 microgram/kg/b.w. at 6 p.m. for 14 consecutive days, starting 7 days before IL-2. IL-2 was given subcutaneously at a dose of 3 million IU twice/daily for 5 days/week for 3 weeks. The increase in serum levels of the specific macrophage marker neopterin, induced by IL-2, was completely blocked by IL-3. The IL-2-induced SIL-2R rise was significantly lower during IL-3 plus IL-2 than under IL-2 alone. The increase in cortisol levels in response to IL-2 was neutralised by IL-3. The increase in lymphocyte, T lymphocyte, natural killer (NK) cell, activated T lymphocyte and eosinophil mean number was significantly higher during IL-3 plus IL-2 than during IL-2 alone. Episodes of fever, asthenia, anorexia, vomiting, anaemia and thrombocytopenia were significantly more frequent in patients receiving IL-2 alone than in those treated with IL-3 and IL-2. This preliminary study would suggest that IL-3 may improve the tolerability of IL-2 immunotherapy and enhance the biological antitumour properties of IL-2 by neutralising cortisol increase and macrophage-mediated suppressive events, with a following potential amplification of Il-2 anticancer efficacy.
Eur J Cancer 1993
PMID:In vivo biological results of the association between interleukin-2 and interleukin-3 in the immunotherapy of cancer. 839 Aug 45

Hepatic undifferentiated mesenchymal sarcoma is a rare pediatric malignant neoplasm. We present three children, aged 7, 8, and 12 years, with this tumor. Clinical presentation was abdominal pain, palpable mass, asthenia, anorexia, and weight loss. One had jaundice. All three lesions were detected on ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI). MRI localized the lesions more accurately than the other methods, with good resectability correlation. On MRI, these tumors were markedly hyperintense on long TR/TE spin-echo (SE) and short-time inversion recovery (STIR) sequences. This was due to the cystic areas with myxoid material and necrosis. The internal separations were hypointense on these sequences. On short TR/TE SE sequences the lesions presented a fibrous pseudocapsule (two cases), and internal hyperintense areas representing hemorrhage (two cases). MRI also detected vascular invasion (one case), biliary obstruction (one case), and hilar adenopathies (one case). The combination of hemorrhage (hyperintense on short TR/TE SE) and cystic or myxoid components (markedly hyperintense on long TR/TE SE and STIR sequences) is common in this tumor.
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PMID:Hepatic mesenchymal sarcoma: MRI findings. 843 59

Rhizoxin is a new anti-tumour agent isolated from the pathogenic fungus Rhizopus chinensis. It has shown broad activity against murine tumour models and is also active against vinca alkaloid-resistant cells. The purpose of our studies was to determine the clinical activity of this compound in patients with advanced breast cancer and melanoma. Based on the results of a phase I study, 2.0 mg m-2 was administered as intravenous infusion over 5 min every 21 days. Nineteen patients were entered into the breast cancer phase II trial and received a total of 50 courses (median 2, range 1-6). Of these, dose reductions were performed in three courses because of leucopenia or stomatitis (1.5 mg m-2, one course; 1.45 mg m-2, two courses). Twenty-six patients were entered into the melanoma trial and received a total of 70 courses (median 2, range 1-12). No dose reductions were required. All patients were eligible for toxicity. Haematological toxicity included neutropenia CTC grade 3 (29/120 courses, 24.2%) and grade 4 (11/20 courses, 9.2%). Only drug-related CTC grade 1 thrombocytopenia was observed. Non-haematological toxicity included alopecia in all patients after two courses of treatment as well as CTC grade 3/4 stomatitis and asthenia. In the breast cancer study, one patient achieved a more than 50% tumour reduction after six cycles but was progressing after 6 weeks. Another patient showed a partial remission after the first course but was taken off the study because of CTC grade 3 skin toxicity. One patient was not evaluable for response (early death). No objective remissions were observed in 15 evaluable patients. In melanoma, no objective remissions were observed. We conclude that rhizoxin can be safely administered at 2.0 mg m-2 every 3 weeks. However, it has little activity in patients with advanced breast cancer and melanoma.
Br J Cancer 1996 Feb
PMID:Phase II clinical trials with rhizoxin in breast cancer and melanoma. The EORTC Early Clinical Trials Group. 856 49

To test the anti-tumour activity of rhizoxin in recurrent and/or metastatic squamous cell head and neck cancer, we performed a phase II study. Eligibility required histologically proven squamous cell head and neck cancer. Patients could only have received one prior chemotherapy. Patients were entered if WHO PS was < or = 2 and organ functions were normal. Treatment consisted of rhizoxin 1.5-2.0 mg m-2 i.v. bolus injection once every 3 weeks. Thirty-two patients entered the study. All were eligible, 31 were evaluable for toxicity and 25 for response. Toxicity mainly consisted of pain at the tumour site and leucocytopenia. Mild asthenia and stomatitis were also observed. Two objective partial responses, lasting 7.5 and 3.5 months, were seen. Rhizoxin at this dose and schedule has minor activity in recurrent and/or metastatic squamous cell head and neck cancer.
Br J Cancer 1996 Feb
PMID:Phase II study of rhizoxin in squamous cell head and neck cancer. The EORTC Early Clinical Trials Group. 856 50

Cachexia is a frequent and devastating complication of advanced cancer. Current understanding of the pathophysiology of this syndrome implicates tumour induced metabolic changes and immune responses. Clinical manifestation include anorexia, chronic nausea, asthenia and change in body image. Aggressive nutritional intervention has not been shown to be of benefit. Patients and families should be counselled about the goals of nutritional intake. In selected cases, enteral nutrition may be appropriate. Pharmacological management should first be directed at correcting nausea. Agents of potential usefulness in the treatment of anorexia include corticosteroids, megestrol acetate, cyproheptadine, hydrazine sulphate and dronabinol. Future research should further address pathophysiology, symptomatic and metabolic effects of interventions and interactions with other syndromes of terminal cancer.
Cancer Surv 1994
PMID:Anorexia and cachexia in advanced cancer patients. 856 2

30 patients with malignant pleuritis were randomised to be treated, either with intrapleural instillation of mepacrine chloride or with mitoxantrone. The patients were evaluated with chest X-ray and a symptom questionnaire during a follow-up period of 12 weeks. Mitoxantrone levels in the pleural space and plasma were measured at different time points in some of the patients. High concentrations of mitoxantrone were found in the pleural fluid while the plasma concentrations were low, giving a plasma/intracavity ratio generally of less than 1:60. The chest X-rays showed excellent results for both treatment modalities. However, the patients treated with mepacrine chloride experienced greater discomfort with fever and pain, and those treated with mitoxantrone reported significantly less dyspnoea and less asthenia after 4 weeks. We conclude that both treatments are equally effective in preventing the recurrence of malignant effusion. However, mitoxantrone seems to have further advantages when it comes to improving the quality of life.
Eur J Cancer 1995 Dec
PMID:Effects of intrapleural mitoxantrone and mepacrine on malignant pleural effusion--a randomised study. 865 43

Predominant characteristics of idiopathic pulmonary hemosiderosis (IPH), a rare pathology of unknown etiology, are recurrent alveolar hemorrhage, hemoptysis and iron deficiency anemia. No evidence of vascular disorders, infections, cancer, pulmonary embolus, veno-occlusive diseases must also be considered for the diagnosis. A case of chronic IPH with long asymptomatic periods and stages of riacutization with severe dyspnoea, high fever, cough with rusty coloured spitting, asthenia and serious respiratory insufficiency is described. The patient adds to our understanding in one of such riacutization in that she agreed to high-resolution computed tomography (HRCT) testing, in addition to common routine testing. It became possible to underline the importance of HRCT both in the diagnosis of IPH without hemoptysis, awaiting invasive investigations like fiberoptic bronchoscopy and lung biopsy, and in the clinical evaluation of the riacutization. Such analysis leads to forwarding the installment of the most appropriate therapy and to the limitation of fibrotic evolution, when possible.
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PMID:[Idiopathic pulmonary hemosiderosis. Clinical and radiological assessment of re-exacerbation]. 876 59


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