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.

Influence of weekday of admission and level of distress on length of hospital stay in patients with low back pain: a retrospective cohort study.

Background: Low back pain (LBP) is often a complex problem requiring interdisciplinary management to address patients' multidimensional needs. Providing inpatient care for patients with LBP in primary care hospitals is a challenge. In this setting, interdisciplinary LBP management is often unavailable during weekends.

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.

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.

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.

Early combined parenteral and enteral nutrition for pancreaticoduodenectomy - Retrospective cohort analysis.

Background: Suggested guidelines for nutritional support after pancreaticoduodenectomy are still controversial. Recent evidence suggests that combining enteral nutrition (EN) with parenteral nutrition (PN) improves outcome. For ten years, patients have been treated with Early Combined Parenteral and Enteral Nutrition (ECPEN) after PD.

[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.

Branched-chain amino acid supplementation during a 100-km ultra-marathon--a randomized controlled trial.

Ultra-marathon running is supposed to increase the parameters of skeletal muscle damage and impair renal function. The purpose of this study was to investigate the effect of branched-chain amino acid supplementation on skeletal muscle damage and renal function during a 100-km ultra-marathon. Twenty-eight athletes were randomly divided into two groups, one group using branched-chain amino acid supplementation (BCAA) and a control group (CON).

No effect of short-term amino acid supplementation on variables related to skeletal muscle damage in 100 km ultra-runners - a randomized controlled trial.

Background: The purpose of this study was to investigate the effect of short-term supplementation of amino acids before and during a 100 km ultra-marathon on variables of skeletal muscle damage and muscle soreness. We hypothesized that the supplementation of amino acids before and during an ultra-marathon would lead to a reduction in the variables of skeletal muscle damage, a decrease in muscle soreness and an improved performance.

Methods: Twenty-eight experienced male ultra-runners were divided into two groups, one with amino acid supplementation and the other as a control group.

Prevalence of exercise-associated hyponatremia in male ultraendurance athletes.

Objective: The prevalence of exercise-associated hyponatremia (EAH) has mainly been investigated in marathoners and Ironman triathletes. The aim of this study was to investigate the prevalence of EAH in male ultraendurance athletes in other disciplines, such as ultraswimming, ultracycling, and ultramarathon running.

Design: Observational field study.

No fluid overload in male ultra-runners during a 100 km ultra-run.

We investigated the change in body composition and hydration status in 27 male ultra-runners during a 100 km ultra-run. The athletes drank fluids ad libitum during the run; intake of calories, fluids, and electrolytes during performance were determined. Body mass decreased by 1.

Maintained total body water content and serum sodium concentrations despite body mass loss in female ultra-runners drinking ad libitum during a 100 km race.

We investigated in 11 female ultra-runners during a 100 km ultra-run, the association between fluid intake and prevalence of exercise-associated hyponatremia in a cross-sectional study. Athletes drank ad libitum and recorded their fluid intake. They competed at 8.

[Risk factors for falls and fall-related injuries in an acute care hospital--a retrospective case control study].

Falls in patient are a major problem in acute care institutions because of direct and indirect consequences. The objectives of the present retrospective case control study were to explore predictors of falls and fall-related injuries in hospitalised patients in a department of internal medicine at a Swiss acute care hospital. The sample included 228 hospitalised patients with a fall and 228 patients without a fall as control subjects, matched by age, gender and medical diagnosis.

Nutritional counseling improves quality of life and nutrient intake in hospitalized undernourished patients.

Objective: Up to 60% of hospitalized patients are undernourished. We studied the impact of nutritional therapy on quality of life and food intake.

Methods: Undernourished patients were randomized into two groups.

Prevalence of undernutrition on admission to Swiss hospitals.

Background & Aims: According to the literature, undernutrition is prevalent in 20-60% of patients on hospital admission. The differences in the rate of undernutrition arise from different diagnostic tools used in the studies. We aimed to investigate the prevalence of undernutrition in Swiss hospitals using a standardized screening tool.

Does increasing blood pH stimulate protein synthesis in dialysis patients?

Background: Although the mechanism of muscle wasting in end-stage renal disease is not fully understood, there is increasing evidence that acidosis induces muscle protein degradation and could therefore contribute to the loss of muscle protein stores of patients on hemodialysis, a prototypical state of chronic metabolic acidosis (CMA). Because body protein mass is controlled by the balance between synthesis and degradation, protein loss can occur as result of either increased breakdown, impaired synthesis, or both. Correction of acidosis may therefore help to maintain muscle mass and improve the health of patients with CMA.

[Homeparenteral nutrition or nutrition for life].

We describe the management of HPN on the basis of a case report. Since TPN is associated with severe complications such as catheter-related sepsis, thrombosis of venous access, metabolic disorders and liver disease, education and peer support of HPN-patients is an important issue and is associated with reduced depression, reduced septic complications and improved QoL. Although SBTx has advanced in the last years, SBTx is only an option when TPN failed, as survival rates after SBTx are still low compared to treatment with TPN.

Serumalbumin--a qualified parameter to determine the nutritional status?

Objectives: The primary objective of the study was to evaluate the relationship between serum albumin concentration and nutritional status. As a secondary objective, correlations between nutritional status, the length of hospital stay, the number of drugs taken and patients' age were assessed.

Methods: In a mono-centre non-interventional trial hospitalised patients were screened for undernutrition.