Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0006625 (cachexia)
 5,650 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Managing the symptoms of advanced disease at the end of life is one of the most challenging aspects of medicine for most clinicians. Traditional textbooks provide limited resources for treating patients at this stoichiometric point in their disease. This article provides an overview in the treatment of common symptoms at the end of life, such as anxiety, anorexia and cachexia, constipation, delirium, dyspnea, fatigue and asthenia, nausea and vomiting, malignant intestinal obstruction, and terminal restlessness. By addressing these symptoms, the physician can play a key role in the patient's achievement of a peaceful, symptom-free, and dignified death in the setting of their choice.
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PMID:Symptom management in hospice and palliative care. 1150 77

In ovarian cancer patients the poor nutritional status and cachexia are caused by the metabolic effects of the enlarging tumor masses and bowel obstruction. These patients may have a high resting energy expenditure due to increase in Cori cycle activity, glucose and triglyceride-fatty acid cycling and gluconeogenesis. Biochemical mediators of cachexia include cytokines, such as tumor necrosis factor and interleukin-6, and tumor-produced catabolic factors, such as lipid-mobilizing factor, proteolysis-inducing factor, and anemia-inducing factor. Mechanisms involved in the pathogenesis of obstruction may include extrinsic occlusion of the bowel due to pelvic, mesenteric omental masses, or intestinal motility disorders due to infilor tration of the mesentery or bowel muscle and nerves. The relief of malnutrition and cachexia may be attempted through nutritional support, pharmacological approach (megestrol acetate, cyclooxygenase inhibitors) and palliative treatment of bowel obstruction. Very few agents have been demonstrated to have true anticachectic activity, so future research should be addressed to the identification of drugs able to block the activity of tumor-produced catabolic factors. The decision regarding optimum management of bowel obstruction should be individualized. Krebs' and Goplerud's score (based on age, nutritional status, tumor status, ascites, previous chemotherapy and irradiation) seems to offer reliable eligibility criteria for those patients who can benefit from surgery.
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PMID:Malnutrition and cachexia in ovarian cancer patients: pathophysiology and management. 1171 91

We report a rare case of extramedullary plasmacytoma, which arose either in the ileum or the ileal mesentery. A 70-year-old woman presented with a high fever and symptoms of bowel obstruction. Computed tomography and magnetic resonance imaging showed a large heterogeneous tumor in the peritoneal cavity. Serum immunoelectrophoresis revealed a biclonal increase of IgA-Kappa and IgG-Kappa. At surgery, we found that the parenchyma of the fragile tumor had firm communication with the ileal mesentery, and the cavity of the tumor communicated with the ileal lumen. After a temporary regression following surgery and chemotherapy, the tumor grew rapidly. Although there was no evidence of progression to multiple myeloma, the patient died of cachexia less than 4 months after surgery.
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PMID:Biclonal extramedullary plasmacytoma arising in the peritoneal cavity: report of a case. 1505 59

The key points of this article are anorexia and cachexia are: A major cause of cancer deaths. Several drugs are available to treat anorexia and cachexia. Dyspnea in cancer usually is caused by several factors. Treatment consists of reversing underlying causes, empiric bronchodilators, cortico-steroids--and in the terminally ill patients-opioids, benzodiazepines,and chlorpromazine. Delirium is associated with advanced cancer. Empiric treatment with neuroleptics while evaluating for reversible causes is a reasonable approach to management. Nausea and vomiting are caused by extra-abdominal factors (drugs,electrolyte abnormalities, central nervous system metastases) or intra-abdominal factors (gastroparesis, ileus, gastric outlet obstruction, bowel obstruction). The pattern of nausea and vomiting differs depending upon whether the cause is extra- or intra-abdominal. Reversible causes should be sought and empiric metoclopramide or haloperidol should be initiated. Fatigue may be caused by anemia, depression, endocrine abnormalities,or electrolyte disturbances that should be treated before using empiric methylphenidate. Constipation should be treated with laxatives and stool softeners. Both should start with the first opioid dose.
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PMID:Common symptoms in advanced cancer. 1583 69

Pancreatic cancer is one of the most lethal malignancies. An estimated 32,300 patients will die of pancreatic cancer in year 2006. It is the tenth most common malignancy in the United States. Despite recent advances in pathology, molecular basis and treatment, the overall survival rate remains 4% for all stages and races. Palliative care represents an important aspect of care in patient with pancreatic malignancy. Identifying and treating disease related symptomology are priorities. As a physician taking care of these patients it is essential to know these symptoms and treatment modalities. This review discusses symptom management and supportive care strategies. Common problems include pain, intestinal obstruction, biliary obstruction, pancreatic insufficiency, anorexia-cachexia and depression. Success is needed in managing these symptoms to palliate patients with advanced pancreatic cancer. Pancreatic cancer is a model illness to learn the palliative and supportive management in cancer patient. It is important for oncologists to recognize the importance of control measures and supportive measures that can minimize the symptoms of advanced disease and side effects of cancer treatment.
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PMID:Supportive and palliative care of pancreatic cancer. 1735 51

The adrenalin index as used in this paper means the amount of adrenalin in milligrams per gram of gland. As in our hands the chemical colorimetric method has proved more accurate, these values rather than the physiological values will be given in the final analysis. The two adrenal glands in the same individual as a rule contain about the same amount of adrenalin per gram, but variations of 10 to 20 per cent. are not unusual. Normal dogs show an index which may vary from 1.2 to 1.8 milligrams. The dogs were killed by short ether anesthesia and bleeding from the carotid. Normal human beings, dying from trauma, rupture of aneurysm, etc., show an index of 0.35 to 0.50 of a milligram, when autopsy takes place a few hours after death. Deterioration of uncut glands or of a gland hash kept on ice in the dark is not rapid and rarely exceeds 10 per cent. in twenty-four hours. Acute intoxication in dogs shows a low adrenalin index, especially the intoxication associated with intestinal obstruction and the closed intestinal loop. Intravenous injection of the poison found in closed duodenal loops sufficient to cause fatal shock causes a great drop in the adrenalin index, at times to one fourth normal or even lower. After recovery from a sublethal toxic dose the adrenalin index may rise rapidly to a point considerably above normal. The same may hold for recovery after chloroform poisoning. Anesthesia by chloroform or ether causes a drop in the adrenalin index depending upon the length of anesthesia and probably in part on the depth of anesthesia. Liver poisons (chloroform, phosphorus, hydrazine) cause a drop in the adrenal index to a low level, perhaps one half normal in acute cases. Pancreas extirpation with prolonged glycosuria and death produces a great drop in the adrenalin index (cat). There is evidence that this may hold in some cases of human diabetes. In man disease of one adrenal (tuberculosis) may be associated with an adrenalin index of double the normal value in the intact adrenal. Pernicious anemia is the only disease so far found to present an abnormally high adrenalin index, and the single case shows an index at least twice normal. This is of interest especially in relation to the views recently put forward to indicate that the spleen and adrenal may be concerned in the lipoid metabolism which is thought to be profoundly disturbed in this disease. Secondary anemia due to repeated hemorrhage or the intoxication of cancer or tuberculosis causes a fall in the adrenalin index. Cachexia due to neoplasm or tuberculosis may cause a marked fall in the adrenalin index, perhaps to less than one half of normal. Acute infections (typhoid fever), septicemia, peritonitis, and similar conditions may be associated with a normal adrenalin index or one somewhat below normal. Diseases of the kidneys, heart, or blood vessels associated with elevated blood pressure show no constant variation in the adrenalin index, which may be normal or slightly subnormal.
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PMID:THE ADRENALIN INDEX OF THE SUPRARENAL GLANDS IN HEALTH AND DISEASE. 1986 91

The biology of ovarian carcinoma differs from that of hematogenously metastasizing tumors because ovarian cancer cells primarily disseminate within the peritoneal cavity and are only superficially invasive. However, since the rapidly proliferating tumors compress visceral organs and are only temporarily chemosensitive, ovarian carcinoma is a deadly disease, with a cure rate of only 30%. There are a number of genetic and epigenetic changes that lead to ovarian carcinoma cell transformation. Ovarian carcinoma could originate from any of three potential sites: the surfaces of the ovary, the fallopian tube, or the mesothelium-lined peritoneal cavity. Ovarian cacinoma tumorigenesis then either progresses along a stepwise mutation process from a slow growing borderline tumor to a well-differentiated carcinoma (type I) or involves a genetically unstable high-grade serous carcinoma that metastasizes rapidly (type II). During initial tumorigenesis, ovarian carcinoma cells undergo an epithelial-to-mesenchymal transition, which involves a change in cadherin and integrin expression and up-regulation of proteolytic pathways. Carried by the peritoneal fluid, cancer cell spheroids overcome anoikis and attach preferentially on the abdominal peritoneum or omentum, where the cancer cells revert to their epithelial phenotype. The initial steps of metastasis are regulated by a controlled interaction of adhesion receptors and proteases, and late metastasis is characterized by the oncogene-driven fast growth of tumor nodules on mesothelium covered surfaces, causing ascites, bowel obstruction, and tumor cachexia.
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PMID:Ovarian cancer development and metastasis. 2518 1

A young man from Jamaica was admitted with cachexia, postprandial epigastric pain and vomiting. His abdominal examination revealed a soft abdomen with hyperactive bowel sounds, the laboratory investigations showed mild anaemia and hypoalbuminaemia, and abdominal x ray showed dilated and oedematous bowel loops. A duodenal biopsy revealed larvae and eggs in the epithelium consisted with Strongyloides infection. In retrospect the patient was found to be HTLV-1 positive. Helminthic infections can present with bowel obstruction even in the absence of eosinophilia or diarrhoea, and should be considered in patients with the appropriate epidemiological background.
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PMID:A young man with bowel obstruction and cachexia. 2168 78

Interprofessional teamwork is a characteristic feature of palliative care. Palliative Care is a subspeciality/ discipline in health care that cares for patients with a life threatening illness. The patient determines individual goals and the extent of further treatment. The team supports patients in decision making, practical advice in symptom management and composition of the future care network. The case of a 58-year-old woman suffering from metastastic breast cancer is an extraordinary example of interprofessional teamwork in palliative care. The patient was hospitalized in a palliative care unit with a malignant bowel obstruction. She underwent ileostomy and chemotherapy. She required total parenteral nutrition and was suffering from anorexia-cachexia syndrome. During her stay in the palliative care unit, her condition deteriorated. Subsequently, her needs changed and she requested to leave the hospital for some days to see her daughter's new domicile. It was by the coordinated effort of the interprofessional palliative care team that this last wish got fulfilled and she died peacefully a few days after her return to the palliative care unit.
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PMID:[Case report - interprofessional teamwork in palliative care]. 2233 2

Colorectal cancer has become a major disease threatening human health. To establish animal models that exhibit the characteristics of human colorectal cancer will not only help to study the mechanisms underlying the genesis and development effectively, but also provide ideal carriers for the screening of medicines and examining their therapeutic effects. In this study, we established a stable, colon cancer nude mouse model highly expressing green fluorescent protein (GFP) for spontaneous metastasis after surgical orthotopic implantation (SOI). GFP- labeled colon cancer models for metastasis after SOI were successfully established in all of 15 nude mice and there were no surgery-related complications or deaths. In week 3, primary tumors expressing GFP were observed in all model animals under fluoroscopy and two metastatic tumors were monitored by fluorescent imaging at the same time. The tumor volumes progressively increased with time. Seven out of 15 tumor transplanted mice died and the major causes of death were intestinal obstruction and cachexia resulting from malignant tumor growth. Eight model animals survived at the end of the experiment, 6 of which had metastases (6 cases to mesenteric lymph nodes, 4 hepatic, 2 pancreatic and 1 mediastinal lymph node). Our results indicate that our GFP-labeled colon cancer orthotopic transplantation model is useful with a high success rate; the transplanted tumors exhibit similar biological properties to human colorectal cancer, and can be used for real-time, in vivo, non-invasive and dynamic observation and analysis of the growth and metastasis of tumor cells.
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PMID:A GFP-labeled human colon cancer metastasis model featuring surgical orthotopic implantation. 2316 25


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