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1.
Nutr. hosp ; 26(4): 677-684, jul.-ago. 2011. ilus, tab
Article in Spanish | IBECS | ID: ibc-111138

ABSTRACT

Introducción: Se estima que dos terceras partes de los pacientes con cáncer sufren de anorexia o pérdida significativa de apetito, lo que conduce a la disminución acentuada de peso y desnutrición, con repercusiones significativas en la calidad de vida y morbimortalidad de los afectados. Aún se desconocen los mecanismos precisos que originan la pérdida de apetito; diversas hipótesis proponen que la patogénesis es multifactorial, destacándose las características biológicas del tumor, del huésped y las relacionadas al tratamiento. Existen nuevas teorías que señalan diversas substancias con efectos antimetabólicos en el sistema nervioso central y que parecen asociarse con resistencia a señales periféricas que informan al hipotálamo sobre el estado de consumo y gasto energético corporal. El objetivo de la revisión es describir conceptos actuales sobre la patogénesis de la anorexia asociada al cáncer, con particular interés en alteraciones del sistema nervioso central. Conclusiones: Es necesario continuar investigando los mecanismos participantes a nivel neural involucrados en la regulación alimentaria, con la finalidad de implementar mejores medidas de alimentación y tratamiento de los pacientes oncológicos con pérdida de apetito, mejorar su estado nutricio, su calidad de vida y sobre todo, reducir la morbimortalidad asociada a desnutrición (AU)


Introduction: Approximately two thirds of cancer patients at advanced stages of the disease suffer from anorexia. Defined as the loss of the desire to eat, anorexia lower the energy intake which further exacerbates a progressive deterioration of the patient nutritional status. Malnutrition has a large impact on morbidity and mortality affecting the quality of life. Cancer anorexia etiologyis multifactorial including complex interactions among the tumor, host metabolism and antineoplastic treatment. New related theories include peripheral and brain mechanisms affecting hypothalamic pathways; inducing behavioral and metabolic failure of responses to energy balance. The aim of this review is to describe actual concepts involved in the pathogenesis of cancer anorexia with special interest in brain mechanisms. Conclusions: Anorexia and reduced food in take are important issues in the management of cancer patients, more knowledge about pathogenic mechanism is needed to improve therapeutic options, prognosis and quality of life in cancer patients (AU)


Subject(s)
Humans , Anorexia/etiology , Neoplasms/complications , Central Nervous System/physiology , Appetite Regulation/physiology , Malnutrition/prevention & control , Risk Factors
2.
Nutr Hosp ; 26(4): 677-84, 2011.
Article in Spanish | MEDLINE | ID: mdl-22470010

ABSTRACT

INTRODUCTION: Approximately two thirds of cancer patients at advanced stages of the disease suffer from anorexia. Defined as the loss of the desire to eat, anorexia lower the energy intake which further exacerbates a progressive deterioration of the patient nutritional status. Malnutrition has a large impact on morbidity and mortality affecting the quality of life. Cancer anorexia etiology is multifactorial including complex interactions among the tumor, host metabolism and antineoplastic treatment. New related theories include peripheral and brain mechanisms affecting hypothalamic pathways; inducing behavioral and metabolic failure of responses to energy balance. The aim of this review is to describe actual concepts involved in the pathogenesis of cancer anorexia with special interest in brain mechanisms. CONCLUSIONS: Anorexia and reduced food intake are important issues in the management of cancer patients, more knowledge about pathogenic mechanism is needed to improve therapeutic options, prognosis and quality of life in cancer patients.


Subject(s)
Anorexia/etiology , Anorexia/physiopathology , Neoplasms/complications , Neoplasms/physiopathology , Nervous System/physiopathology , Anorexia/diagnosis , Anorexia/therapy , Brain/physiopathology , Cytokines/blood , Eating/physiology , Hormones/blood , Humans , Malnutrition/etiology , Neoplasms/therapy , Neurotransmitter Agents/blood , Nutritional Status
4.
Rev Invest Clin ; 45(6): 559-64, 1993.
Article in Spanish | MEDLINE | ID: mdl-8159876

ABSTRACT

During the period of May 1986 through February 1991, nine allogeneic bone marrow transplants (BMT) on eight severe aplastic anemia (SAA) patients were performed at the Instituto Nacional de la Nutrición Salvador Zubirán in Mexico City. Mean age at BMT was 18 years (age interval 12-30); seven were men; all patients had a clinical history of multiple blood transfusions; six individuals were infected at the time of the transplant. The conditioning regimens were: cyclophosphamide (Cy) in three patients; Cy+ total nodal radiation in five; and total nodal radiation only in the second transplant of one patient. Graft versus host disease (GVHD) prophylaxis was attempted with methotrexate plus cyclosporin A (CsA) in six patients, methylprednisolone plus CsA in two, and prednisone + CsA in the patient retransplanted. All procedures were carried out under single reverse isolation without gut decontamination. Seven of the nine procedures grafted (two cases died on days +8 and +25 due to infection). In the surviving, the median time for reaching > 1.0 white blood cells x 10(9)/L was 22 days (time interval 11-31); > 0.5 neutrophils x 10(9)/L in 27 days (time interval 15-42) and the same lapse to reach > 50 platelets x 10(9)/L. Length of hospital stay was 42 days (time interval 15-61). Acute GVHD was seen in one of the seven patients surviving the period of bone marrow aplasia (14%). Of six long term survivors (including one patient with a second transplant) chronic GVHD was present in four (67%): chronic GVHD was fatal in one individual but was well controlled in three.(ABSTRACT TRUNCATED AT 250 WORDS)


Subject(s)
Anemia, Aplastic/surgery , Bone Marrow Transplantation , Actuarial Analysis , Adolescent , Adult , Bone Marrow Transplantation/mortality , Child , Female , Graft vs Host Disease/etiology , Graft vs Host Disease/prevention & control , Humans , Immunosuppressive Agents/therapeutic use , Male , Program Evaluation , Survival Rate , Treatment Outcome
8.
Rev. invest. clín ; 35(1): 55-8, 1983.
Article in Spanish | LILACS | ID: lil-14563

ABSTRACT

Los casos de leucemia aguda em cuya evolucion se presenta un embarazo no han sido frecuentes hasta el momento. Se informan 2 casos con leucemia aguda mieloblastica y uno con linfoblastica que se embarazon estando en remision completa y en tratamiento de mantenimiento con 6-mercaptopurina, ciclofosfamida y methotrexate. En dos casos el producto murio en utero; uno de ellos con grandes malformaciones. El tercero tuvo gemelos univitelinos, uno con minimas malformaciones, pero estudios de medula osea y cromosomico normales y ambos en buenas condiciones despues de 2 anos.El embarazo no influyo en la evolucion de la leucemia. Se propone utilizar metodos anticonceptivos en las pacientes leucemicas en edad fertil


Subject(s)
Pregnancy , Adolescent , Humans , Female , Leukemia, Lymphoid , Leukemia, Myeloid, Acute , Pregnancy Complications, Neoplastic , Mercaptopurine , Cyclophosphamide , Methotrexate
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