ABSTRACT
BACKGROUND/OBJECTIVES: Malnutrition and cachexia have a negative impact on the course of treatment in patients with head and neck squamous cell carcinoma (HNSCC). Good evidence exists for the practical use of the bioelectrical impedance analysis (BIA) parameter phase angle (PA) for the evaluation of nutritional and overall health status in cancer patients. In the present study, two hypotheses were tested: that PA can distinguish between malnutrition and cachexia; in non-cachectic patients, pre-treatment PA is predictive for cachexia development during (chemo)radiation. SUBJECTS/METHODS: In 55 head and neck cancer patients, nutritional status was determined by the NRS-2002, anthropometric, laboratory tests and BIA before and after (chemo)radiotherapy. For the diagnosis of cachexia, the international consensus criteria were used. Patients were categorized as well-nourished, malnourished or cachectic. The resulting group distribution was compared with pre- and post-treatment PA values. RESULTS: Before treatment, 69.1% of patients were well-nourished, 16.4% malnourished and 14.5% cachectic; post-treatment proportions were 16.4%, 45.4% and 38.2%, respectively. Well-nourished patients had a higher pre-treatment mean PA value compared with the others (P=0.045). The risk of malnutrition/cachexia increased by 1.71 (95% confidence interval (CI) 1.10-2.66) per mean PA decrease by one unit (P=0.018). In 47 initially non-cachectic patients, PA failed to show any predictive value for cachexia (area under the receiver operating characteristic curve: 0.578, 95% CI 0.385-0.772, P>0.05). CONCLUSIONS: PA did not distinguish between malnourished and cachectic patients with HNSCC, and pre-treatment PA did not predict cachexia development during (chemo)radiation. Nevertheless, PA seems to be a good marker of nutritional status in HNSCC patients.
Subject(s)
Cachexia/etiology , Carcinoma, Squamous Cell/physiopathology , Chemoradiotherapy/adverse effects , Electric Impedance , Head and Neck Neoplasms/physiopathology , Nutrition Assessment , Aged , Carcinoma, Squamous Cell/complications , Carcinoma, Squamous Cell/therapy , Female , Head and Neck Neoplasms/complications , Head and Neck Neoplasms/therapy , Humans , Male , Middle Aged , Nutritional Status , Prospective Studies , ROC Curve , Squamous Cell Carcinoma of Head and NeckABSTRACT
Reuse or reusability is not a specific, algorithmic, heuristic or only a simple set of guidelines. Database reuse means the use of an existing component--a database entity--in a new context, either elsewhere in the same system or in another system. According to different definitions, an intelligent system is a "power tool for thinking"; but on the other side it is only a kind of information system with built-in knowledge to support decisions made by human experts. Similar conclusions could be made for intelligent medical systems and introduce the database reusability in this environment with a purpose to increase the quality of an intelligent medical system. In the paper the problem of the database reusability will be presented more in detail, especially its integration in an intelligent medical system. Finally, the results of such integration and the benefits for the medicine will be discussed.
