Assessing the resting energy expenditure of cancer patients in the Penang General Hospital.

INTRODUCTION: Malnutrition is common in cancer patients. Generally, it is believed that the resting energy expenditure (REE) is elevated in cancer patients and this contributes to the development of malnutrition. Thus, to be able to assess the REE is important in planning adequate nutrition support. METHODS: A cross-sectional study was carried out to assess the REE in patients with solid tumour (n=25), leukemia (n=25) and healthy subjects (n=50) by using the indirect calorimetry method under standard conditions. RESULTS: There was no significant difference between the measured REE among patients with solid tumour, leukemia and the control group (p=0.534). By contrast, there was a significant difference between the REE/kg FFM in solid tumour patients compared to the leukemia group and the healthy subjects, (p=0.049 and p=0.002). The REE derived from the Harris Benedict Equation was found to be significantly higher than the measured REE. The stress factor for patients with solid tumour was 1.35 and that for leukemia patients was 1.36. CONCLUSION: The REE/kg FFM in the cancer patients undergoing anticancer therapy appeared to be higher than expected compared to healthy subjects. The Harris Benedict Equation (HBE) was found to over-estimate the REE of cancer patients in the study. As the total energy expenditure (TEE) is estimated by multiplying the REE with the stress factor and physical activity factor, the overestimated REE from HBE will further increase the risk of overfeeding in this population.

The effects of nickel(II) and chromium(VI) on oxygen demand, nitrogen and metal removal in a sequencing batch reactor.

The objective of this study was to evaluate the effects ofNi(II) and Cr(VI) individually and in combination on the simultaneous removal of chemical oxygen demand (COD), nitrogen and metals under a sequencing batch reactor (SBR) operation. Three identical laboratory-scale SBRs were operated with FILL, REACT, SETTLE, DRAW and IDLE periods in a ratio of 1:12:1:2:8 for a cycle time of 24 h until the steady state was achieved. Nickel(II) at increasing concentrations up to 35 mg/L was added to one of the reactors; Cr(VI) at increasing concentrations up to 25 mg/L was added to a second reactor; while a combination of Ni(II) and Cr(VI) in equal concentrations up to 10 mg/L was added to a third reactor. The results demonstrate that both Ni(II) and Cr(VI) exerted a more pronounced inhibitory effect on the removal of ammonia nitrogen (AN) than on COD removal. Synergistic and antagonistic inhibitory effects on the rates of COD and AN removal, respectively, were observed for the 50% Ni(II) and 50% Cr(VI) (w/w) mixture in the concentration range between 10 and 20 mg/L. The simultaneous presence of 50% Ni(II) and 50% Cr(VI) at a concentration of 20 mg/L resulted in system failure.