Effect of combined therapies including nutrition and physical exercise in advanced cancer patients: A pooled analysis.

Background And Aims: Although many cancer patients suffer from malnutrition or cancer cachexia, there is no standard of care so far due to limited intervention trials. Pooled data from two combined trials were analyzed regarding nutritional status and survival time.

Materials And Methods: Data from two trials with advanced cancer patients were included.

NRS-2002 components, nutritional score and severity of disease score, and their association with hospital length of stay and mortality.

Background: Malnutrition is a substantial issue in hospitals, leading to prolonged length of hospital stay, increased perioperative morbidity and increased mortality. There are several validated screening tools for malnutrition, one of which is the Nutritional Risk Screening 2002 (NRS). It screens patients based on recent weight loss, reduction of recent food intake, body mass index (BMI), severity of disease and age.

Results from an Epidemiological Follow-Up Survey on Home Artificial Nutrition in Switzerland from 2010 to 2015.

Background: Home artificial nutrition (HAN) is an established treatment for malnourished patients. Since July 2012, the costs for oral nutrition supplements (ONS) are covered by the compulsory health insurance providers in Switzerland if the patient has a medical indication based on the Swiss Society for Clinical Nutrition guidelines. Therefore, the purpose of our study was to analyse the development of HAN, including ONS, before and after July 2012.

The well-being of Swiss general internal medicine residents.

Background: Physician well-being has an impact on productivity and quality of care. Residency training is a particularly stressful period.

Objective: To assess the well-being of general internal medicine (GIM) residents and its association with personal and work-related factors.

Effect of a leucine-rich supplement in combination with nutrition and physical exercise in advanced cancer patients: A randomized controlled intervention trial.

Background & Aims: Branched-chain amino acids and specifically leucine stimulate protein synthesis and may overcome an anabolic resistance in malnourished and cachectic cancer patients. Therefore, we hypothesized that the addition of a leucine-rich supplement to a multimodal therapy improves physical function in advanced cancer patients.

Methods: This single center, randomized trial examined a multimodal therapy over 12 weeks in patients with advanced cancer.

Nutrition in Gastrointestinal Disease: Liver, Pancreatic, and Inflammatory Bowel Disease.

Liver, pancreatic, and inflammatory bowel diseases are often associated with nutritional difficulties and necessitate an adequate nutritional therapy in order to support the medical treatment. As most patients with non-alcoholic fatty liver disease are overweight or obese, guidelines recommend weight loss and physical activity to improve liver enzymes and avoid liver cirrhosis. In contrast, patients with alcoholic steatohepatitis or liver cirrhosis have a substantial risk for protein depletion, trace elements deficiency, and thus malnutrition.

Autopsy case of aortic dissection after transcatheter aortic valve implantation (TAVI).

Aortic dissection is one of the severe but rare vascular complications arising from transcatheter aortic valve implantation (TAVI). This paper presents an autopsy case of an 81-year-old male patient with delayed aortic dissection with underlying haemorrhages and acute inflammation 3 years after TAVI.

Effects of nutrition and physical exercise intervention in palliative cancer patients: A randomized controlled trial.

Background & Aims: Cancer cachexia is multifactorial and should be targeted using a multimodal form of intervention. The purpose of the present trial was to test the effects of a combined nutrition and physical exercise program on cancer patients with metastatic or locally advanced tumors of the gastrointestinal and lung tracts.

Methods: Patients were randomized into two groups: One group received a minimum of three standardized individual nutritional counselling sessions and participated in a 60-min exercise program twice a week.

Are Four Simple Questions Able to Predict Weight Loss in Outpatients With Metastatic Cancer? A Prospective Cohort Study Assessing the Simplified Nutritional Appetite Questionnaire.

Background: Severe weight loss is directly responsible for up to one-fifth of all cancer deaths and has a major impact on quality of life. The simplified nutritional appetite questionnaire (SNAQ) was validated to predict weight loss within 6 mo in community-dwelling adults and nursing home residents.

Methods: We prospectively assessed the SNAQ in 133 palliative cancer outpatients.

ESPEN guideline on ethical aspects of artificial nutrition and hydration.

Background: The worldwide debate over the use of artificial nutrition and hydration remains controversial although the scientific and medical facts are unequivocal. Artificial nutrition and hydration are a medical intervention, requiring an indication, a therapeutic goal and the will (consent) of the competent patient.

Methods: The guideline was developed by an international multidisciplinary working group based on the main aspects of the Guideline on "Ethical and Legal Aspects of Artificial Nutrition" published 2013 by the German Society for Nutritional Medicine (DGEM) after conducting a review of specific current literature.

Management of Home Parenteral Nutrition: A Prospective Multicenter Observational Study.

Background: There are no specific Swiss home parenteral nutrition (HPN) data showing patient characteristics, quality of life (QoL) and complications. The goal of this study was to collect representative nationwide data on current adult HPN patients in Switzerland for international comparability and benchmarking.

Methods: This was a multicenter, nationwide, observational study.

[Comparison of management of ambulatory emergency patients in the family practice and the hospital emergency center].

The increase in health care cost is broadly discussed in the public, either in the hospital or ambulatory setting. With the present study we compared the invoice amount generated by a first doctor's advice in the general practitioner to the one in the emergency room. In addition, we compared the diagnostic procedures used in the general practice to the one in the hospital, and whether the choice of diagnostic procedures would substantially influence the invoice amount.

[Oral nutritional supplements are effective, purposeful and economic].

Numerous studies have shown that medically indicated sip feeding is an effective and cost-saving mean to combat malnutrition. Particularly, acutely ill, elderly, polymorbid internal and surgical patients benefit from sip feeding. In Switzerland, the reimbursement of medically indicated sip feeding at home by the compulsory health insurance is critically important for the good of the patient and cost optimization.

[Epidemiology of malnutrition].

The World Health Organisation classifies malnutrition worldwide as the greatest threat to public health. An expert report of the Council of Europe clearly showed that malnutrition in hospitalised patients is a real existing problem in all European countries, including Switzerland. According to the literature, malnutrition is prevalent in 20 - 60 % of patients on hospital admission.

Influence of a nutritional intervention on dietary intake and quality of life in cancer patients: a randomized controlled trial.

Objective: Weight loss is common in patients with malignant tumors and it can adversely affect quality of life and survival. The aim of the present study was to investigate the effects of a nutritional intervention in cancer patients in an outpatient setting.

Methods: Cancer outpatients (N = 58) who were classified as undernourished or at high risk for undernutrition by the Nutritional Risk Screening 2002 tool were randomized into two groups.

[The use of scores in general medicine].

Scores are tools to combine complex information into a numerical value. In General Medicine, there are scores to assist in making diagnoses and prognoses, scores to assist therapeutic decision making and to evaluate therapeutic results and scores to help physicians when informing and advising patients. We review six of the scoring systems that have the greatest utility for the General Physician in hospital-based care and in General Practice.

Home artificial nutrition in Switzerland: an epidemiological survey from 2005 to 2009.

Background And Aims: Home artificial nutrition (HAN), including oral nutritional supplements (ONS) and enteral (HEN) and parenteral (HPN) nutrition, is an established, important treatment for malnourished patients. The aim of this study was to analyze the epidemiological data of patients on HAN in Switzerland.

Methods: This retrospective study recorded all new cases of HAN in Switzerland from January 2005 to December 2009.

Mucin-producing adenocarcinoma arising in an atrial myxoma.

We describe the unique autopsy findings of a patient who died of a metastasizing giant right atrial adenocarcinoma containing few areas of typical myxoma. That no mucin-producing extracardiac tumor was detected pointed to the atrial adenocarcinoma as being the primary. We hypothesize that the adenocarcinoma may have developed from coexistent bland glandular structures within the myxoma.

[Systemic disease with hepatic and pulmonary involvement].

We discuss the history of a 39 year old woman with multiple patchy consolidations on high - resolution computed tomography in combination with a delayed diagnosis of primary biliary cirrhosis. Further we review the differential diagnostic considerations and step by step diagnostic and therapeutic options. Based on the presentation with symptoms of a mitigated pneumonia at the beginning of the disease, the differential diagnosis of cryptogenic organising pneumonia (CO) is discussed.