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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Animal analogues of anorexia nervosa suggest that submissive behaviour and social defeat may be implicated in the onset of wasting diseases. Data from human sufferers of anorexia nervosa and bulimia nervosa are also consistent with the presence of submissive behaviours and perceived low social rank (e.g. low self-esteem, helplessness, and feelings of shame). A total of 101 patients with eating disorders completed the Submissive Behaviour Scale and the Social Comparison Rating Scale, and their responses were compared with 101 age- and sex-matched student controls. Patients with eating disorders reported significantly higher levels of submissive behaviour and a more unfavourable social comparison than did student controls. Furthermore, levels of submissive behaviour and unfavourable social comparison were significantly related to severity of eating disorder symptoms, even after taking account of depressive symptoms and other psychopathology. These preliminary results suggest that ranking theory may have some application to eating disorders. Further research is required to determine whether rank plays a specific role in eating disorders (beyond the increased rates of depression which also occur in eating disorders) and, if so, what is its precise role.
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PMID:Social comparison and submissive behaviour in eating disorder patients. 1457 91

Hypogonadism is highly prevalent in HIV-infected patients and has been associated with the late stages of AIDS and AIDS wasting. There are a number of studies exploring treatment options. Testosterone replacement, with the exception of the transscrotal delivery patch, has been observed to have a beneficial effect on lean body mass and body weight in hypogonadal and eugonadal men with the AIDS wasting syndrome. Resistance exercise training also has had favorable effects on body weight and muscle cell mass. In hypogonadal men with AIDS treated with testosterone replacement therapy, researchers noted a positive effect on depression scores.
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PMID:Testosterone replacement for hypogonadism: clinical findings and best practices. 1495 95

CAUSATIVE FACTORS: Nutritional supplementation or pharmacological manipulation of appetite are unable to control the muscle atrophy seen in cancer cachexia. This suggests that tumour and/or host factors might be responsible for the depression in protein synthesis and the increase in protein degradation. An increased expression of the ubiquitin-proteasome proteolytic pathway is responsible for the increased degradation of myofibrillar proteins in skeletal muscle, and this may be due to tumour factors, such as proteolysis-inducing factor (PIF), or host factors such as tumour necrosis factor-alpha (TNF-alpha). In humans loss of adipose tissue is due to an increase in lipolysis rather than a decrease in synthesis, and this may be due to tumour factors such as lipid-mobilising factor (LMF) or TNF-alpha, both of which can increase cyclic AMP in adipocytes, leading to activation of hormone-sensitive lipase (HSL). Levels of mRNA for HSL are elevated twofold in adipose tissue of cancer patients, while there are no changes in lipoprotein lipase (LPL), involved in extraction of fatty acids from plasma lipoproteins for storage. TREATMENT FOR CACHEXIA: This has concentrated on increasing food intake, although that alone is unable to reverse the metabolic changes. Agents interfering with TNF-alpha have not been very successful to date, although more research is required in that area. The only agent tested clinically that is able to interfere with the action of PIF is eicosapentaenoic acid (EPA). EPA attenuates protein degradation in skeletal muscle by preventing the increased expression of the ubiquitin-proteasome pathway, but has no effect on protein synthesis. When used alone EPA prevents further wasting in cachectic patients, and, when it is combined with an energy- and protein-dense nutritional supplement, weight gain is seen, which is totally lean body mass. These results suggest that mechanistic studies into the causes of cancer cachexia will allow appropriate therapeutic intervention.
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PMID:Cancer cachexia. 1516 25

With the advent of potent combination antiretroviral therapy (ART), there has been a reduction in the incidence of wasting. However, few studies have investigated specific body composition changes associated with these treatments. This study aimed to investigate longitudinally the association of increasingly potent ART with changes in body cell mass and wasting utilizing bioelectric impedance analysis (BIA). In this longitudinal cohort study, 159 HIV-positive men were assessed semiannually from 1995 to 1997 for body composition utilizing BIA, CD4 lymphocyte count, HIV viral load, medical and depressive symptoms. Wasting was defined as body cell mass/height below the 90th percentile based on HIV positive norms. ART potency at each visit was scored utilizing published clinical guidelines, ranging from 1 (0-1 antiretrovirals) to 5 (3 or more antiretrovirals including a potent protease inhibitor). Viral resistance testing was not used. The mixed-effects model and the generalized estimating equations approaches were used to determine longitudinal correlates of body cell mass and of wasting, respectively. Over the 2 years of follow-up, potent combination ART use increased from 6% to 79%. Concurrently, a significant increase in mean body cell mass and a reduction in prevalence of wasting were seen, while total body weight, fat mass, and total body water did not change. Increasingly potent ART was associated with significant increases in body cell mass and reduction in wasting. Other significant correlates of increased body cell mass included higher CD4 count and decreased severity of HIV-related symptoms, fatigue and depression. The current study found that higher potency ART taken for relatively short term (2 years) was associated with an increase in body cell mass and a reduction in wasting and that these changes were associated with both medical (CD4, HIV symptoms) and behavioral (fatigue, depression) improvements. One caveat is this study did not distinguish among types of potent ART regimens. Given only some antiretrovirals appear linked to many body composition changes, regardless of their effect on viral load, it may be the type of regimen used that accounted for the relationship seen between viral load and body composition changes.
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PMID:Increase in body cell mass and decrease in wasting are associated with increasing potency of antiretroviral therapy for HIV infection. 1585 93

Megabacteriosis was diagnosed as the cause of depression and wasting in a flock of breeding budgerigars in the Manawatu. Large numbers of megabacteria were detected in direct smears from mucosal scrapings of the proventriculus of two birds and in the faeces of live birds. The diagnosis was confirmed by demonstrating a chronic proventriculitis histologically associated with megabacterial organisms. Treatment of seven individuals with amphotericin B resulted in clinically sustained weight gain over a 10-week period. Treatment of the whole flock resulted in the resumption of normal condition, behaviour and activity.
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PMID:Megabacteriosis in a flock of budgerigars. 1603 86

Acute (i.e., wasting) pediatric malnutrition consistently elevates blood glucocorticoid levels, but neither the magnitude of the rise in concentration nor its kinetics is clear. Male and female C57BL/6J mice, initially 19 days old, and CBA/J mice, initially 23 days old, consumed a complete purified diet either ad libitum (age-matched control) or in restricted daily quantities (mimicking marasmus), or they consumed a purified isocaloric low-protein diet ad libitum (mimicking incipient kwashiorkor). Serum levels of corticosterone were assessed by double antibody radioimmunoassay after 3, 6, and 14 days (C57BL/6J strain) or after 6 and 14 days in the genetically distant CBA/J strain. Age-matched control groups of both strains exhibited mean corticosterone levels of 5-30 ng/ml, whereas the acutely malnourished groups exhibited mean levels of this hormone that were elevated by more than an order of magnitude as early as 3 days after initiation of weight loss. This outcome was confirmed in a second experiment in which the serum corticosterone level of C57BL/6J weanlings was examined by competitive binding enzyme immunoassay 3 and 14 days after initiation of the dietary protocols. Therefore, deficits of protein and/or energy in weanling murine systems relevant to acute pediatric malnutrition elicit early elevations in blood glucocorticoid levels to a magnitude reminiscent of critical illness and multiple trauma. The key to this novel finding was an exsanguination method that permitted accurate assessment of the blood corticosterone level of the healthy, quiescent mouse. Overall, the results of this investigation provide a new perspective on the glucocorticoids as part of the early hormonal response to acute weanling malnutrition coincident with the shift toward catabolic metabolism and the initiation of depression in cellular immune competence.
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PMID:Blood corticosterone concentration reaches critical illness levels early during acute malnutrition in the weanling mouse. 1651 71

The evaluation of quality of life (QoL) assesses patients' well-being by taking into account physical, psychological and social conditions. Cancer and its treatment result in severe biochemical and physiological alterations associated with a deterioration of QoL. These metabolic changes lead to decreased food intake and promote wasting. Cancer-related malnutrition can evolve to cancer cachexia due to complex interactions between pro-inflammatory cytokines and host metabolism. Beside and beyond the physical and the metabolic effects of cancer, patients often suffer as well from psychological distress, including depression. Depending on the type of cancer treatment (either curative or palliative) and on patients' clinical conditions and nutritional status, adequate and patient-tailored nutritional intervention should be prescribed (diet counselling, oral supplementation, enteral or total parenteral nutrition). Such an approach, which should be started as early as possible, can reduce or even reverse their poor nutritional status, improve their performance status and consequently their QoL. Nutritional intervention accompanying curative treatment has an additional and specific role, which is to increase the tolerance and response to the oncology treatment, decrease the rate of complications and possibly reduce morbidity by optimizing the balance between energy expenditure and food intake. In palliative care, nutritional support aims at improving patient's QoL by controlling symptoms such as nausea, vomiting and pain related to food intake and postponing loss of autonomy. The literature review supports that nutritional care should be integrated into the global oncology care because of its significant contribution to QoL. Furthermore, the assessment of QoL should be part of the evaluation of any nutritional support to optimize its adequacy to the patient's needs and expectations.
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PMID:Nutritional intervention and quality of life in adult oncology patients. 1736 56

Quality of life (QOL) is a concept assessing physical, psychological and social factors which are influencing the patients' well being. Cancer and its therapy induce severe metabolic changes associated with QOL impairment. These alterations contribute to an increased energy wasting and a decreased food intake. Besides, it may lead to tumoral cachexia due to the complex interactions between pro-inflammatory cytokines and the host metabolism. On the other hand, and beyond physical impairments and metabolic effects from cancer, patients often suffer from psychological stress, such as depression. A nutritional intervention should be implemented as soon as cancer is diagnosed. It should be appropriate to the individual needs of the patient, considering the type of oncologic treatment (whether it is curative or palliative), the clinical conditions and the nutritional status. The aim is to reduce or even revert nutritional status impairment, improve the general condition, and subsequently improve quality of life. The primary focus of nutritional intervention accompanying oncologic treatment intended to cure is on the optimization of the balance between energy waste and food intake. Thus trying to achieve further specific purposes such as a decrease of rate of complications and an amelioration of the response and tolerance to the oncologic therapy. The purpose of nutritional support in palliative care is controlling the symptoms related to food intake and delaying the loss of autonomy. And by this means maintaining or improving patients' QOL. It is corraborated by a literature review, that nutritional therapy should form part of the integral oncological support since it contributes considerably to a QOL improvement. Because of the possibility to identify the patients' needs and expectations by assessing their QOL it should be generally included into their nutritional evaluation to be able to tailor the adequate nutritional support.
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PMID:[Relationship between nutritional intervention and quality of life in cancer patients]. 1972 35

Immune depression associated with prepubescent malnutrition underlies a staggering burden of infection-related morbidity. This investigation centered on dendritic cells as potentially decisive in this phenomenon. C57BL/6J mice, initially 19 days old, had free access for 14 days to a complete diet or to a low-protein formulation that induced wasting deficits of protein and energy. Mice were sensitized by i.p. injection of sheep red blood cells on day 9, at which time one-half of the animals in each dietary group received a simultaneous injection of 10(6) syngeneic dendritic cells (JAWS II). All mice were challenged with the immunizing antigen in the right hind footpad on day 13, and the 24-hour delayed hypersensitivity response was assessed as percentage increase in footpad thickness. The low-protein diet reduced the inflammatory immune response, but JAWS cells, which exhibited immature phenotypic and functional characteristics, increased the response of both the malnourished group and the controls. By contrast, i.p. injection of 10(6) syngeneic T cells did not influence the inflammatory immune response of mice subjected to the low-protein protocol. Antigen-presenting cell numbers limited primary inflammatory cell-mediated competence in this model of wasting malnutrition, an outcome that challenges the prevailing multifactorial model of malnutrition-associated immune depression. Thus, a new dendritic cell-centered perspective emerges regarding the cellular mechanism underlying immune depression in acute pediatric protein and energy deficit.
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PMID:Adoptively transferred dendritic cells restore primary cell-mediated inflammatory competence to acutely malnourished weanling mice. 1820 92

Chronic obstructive pulmonary disease (COPD) is multifactorial, multisystemic, inflammatory disease, whose basic pathophysiogical characteristic is the airflow obstruction caused by airways inflammation, mucociliary dysfunction and structural changes in airways and lung parenchyma. Systemic components, caused by this inflammatory process, are body weight loss, loss and dysfunction of skeletal muscles, osteopathy and osteoporosis, and accompanying cardiovascular diseases and psychic depression. Weight loss, especially loss and dysfunction of skeletal muscles, is the substantial characteristic of COPD that contributes to the level of disability of these patients independently of the degree of the airflow limitation, and has a close connection with the survival. It is assumed, according to the current studies, that different factors contribute to the body weight loss and to the muscle alterations in COPD, and that the relative contribution of each factor seems to differ between patients as well as between muscle types. Because of the important role of wasting in the evolution of COPD, and its influence on health status, quality of life and survival, adequate assessment of body weight, especially muscle mass, has to be considered as an integral part of the pathophysiologic characterization of COPD patients. Reversal of the wasting state is the substantial factor in improvement of quality of life and survival in COPD patients.
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PMID:[Body weight loss in patients with chronic obstructive pulmonary disease]. 1823 84


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