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Unintentional Weight Loss Causes

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181. Nutrition Screening, Assessment, and Intervention in Adult

Screening Tool 14 Appetite, unintentional weight loss Malnutrition Universal Screening Tool 15 BMI, change in weight Presence of acute disease Maastricht Index 16 Percentage ideal body weight Albumin, prealbumin, lym- phocyte count Nutrition Risk Classification 17 Weight loss, percentage ideal body weight, dietary intake Gastrointestinal function Nutritional Risk Index 18 Present and usual body weight Albumin Nutritional Risk Screening 2002 19 Weight loss, BMI, food intake Diagnosis (severity (...) in peer-reviewed publications and their fre- quent use by A.S.P.E.N. members and other healthcare professionals in clinical practice, academia, research, and Table 1. Selected Nutrition Screening and Assessment Instrument Parameters Instrument Anthropometry and/or Diet- Related Severity of Illness Other (Physical, Psychological Variables or Symptoms) Screening tools Birmingham Nutrition Risk Score 13 Weight loss, BMI, appetite, ability to eat Stress factor, (severity of diagnosis) Malnutrition

2011 American Society for Parenteral and Enteral Nutrition

182. From The Archives: The Skinny on Cachexia?Can it be Treated?

rheumatologic diseases (1). Cytokines are elevated in pro-inflammatory states and have been found to cause an activation of proteolysis and lipolysis (2, 3). Many tumors are known to produce their own cytokines, which were found to cause a decreased appetite and weight loss in animal models (4). The activity of the various cytokines involved produces a net negative energy balance in the patient suffering from a chronic disease. There are several other implicated hormonal factors that may induce cachexia (...) with a poor nutritional state will continue to be a difficult problem. Peer Review/Commentary by Theresa Ryan, MD Assistant Professor of Medicine, NYU Division of Medical Oncology: Anorexia-Cachexia Syndrome, or ACS, affects up to 80% of patients with advanced solid tumor malignancies. Although definitions vary, ACS is typically defined as a weight loss of > 5% of a patient’s pre-illness weight over a 2-6month period. ACS causes both physical and psychological distress and is associated with early

2011 Clinical Correlations

183. Preventing falls and harm from falls in older people

aged 65 years and older. However, this age limit need not be rigidly applied in implementing initiatives. A fall is defined as ‘a sudden, unintentional change in position causing an individual to land at a lower level, on an object, the floor, or the ground, other than as a consequence of a sudden onset of paralysis, epileptic seizure, or overwhelming external force’ xxviii . Strategies under the policy may focus on reducing falls and/ or on reducing the harm that occurs should a fall take place (...) . Harms caused by falls among older people include physical harm, such as fractures and traumatic brain injury and also negative psychological and functional impacts, such as loss of confidence in undertaking daily activities and inappropriate activity restriction. Obsolete Prevention of Falls and Harm from Falls among Older People 2011–2015 NSW Healt H Pa Ge 7 SECTION 3 Areas of action The following areas of action for NSW Health in prevention of falls among older people have been designed to provide

2011 Clinical Practice Guidelines Portal

184. Exercise and Sports Science Australia position statement on exercise and falls prevention in older people

Health, Injury Prevention Policy Unit; 2000. 7. Sjogren H, Bjornstig U. Unintentional injuries among elderly people: incidence, causes, severity, and costs. Acc Anal Prev 1989;21(3):233–42. 8. Carroll N, Slattum P, Cox F. The cost of falls among the community- dwelling elderly. J Manage Care Pharm 2005;11:307–16. 9. Scuffham P, Chaplin S, Legood R. Incidence and cost of unintentional falls in older people in the United Kingdom. J Epidemiol Community Health 2003;57:740–4. 10. Tiedemann AC, Murray SM (...) or more times every year. 1 Falls can also result in disability, loss of mobility, reduced quality of life and fear of falling. 2 The rate of falling is even higher in residents of aged care facilities and in hospital patients. 3 Fall rates and the risk of multiple falls also increase signi?cantly with age. 4 Most falls result in only minor injuries, however * Corresponding author at: The George Institute for Global Health, PO Box M201, Missenden Rd, NSW 2050, Australia. E-mail address: atiedemann

2011 Clinical Practice Guidelines Portal

185. Limb Lengthening Using the PRECICETM Nail System: Complications and Results (PubMed)

posttraumatic (n = 5) and congenital (n = 4). The mean LLD was 36.4 ± 11.4 mm. The minimum follow-ups were 2 months (average, 5 months; range, 2 - 9 months).The mean distraction rate was 0.5 ± 0.1 mm/day. We observed in 7 patients differences in achieving the lengthening goals (average, 1.6 mm; range, -20.0 - 5.0 mm). Average lengthening was 34.7 ± 10.7 mm. All patients reached normal alignment and normal joint orientation. An unintentional loss of the achieved length during the consolidation phase (...) was noticed in patients with delayed bone healing in two cases. In the first case (loss of 20mm distraction) the nail could be redistracted and the goal length was achieved. In the second case (loss of 10mm distraction) the nail broke shortly after the diagnosis and the nail was exchanged.We report of loss of achieved length after lengthening with a telescopic nail. Weight bearing before complete consolidation of the regenerate might be a risk factor for that. Thorough examination of the limb length

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2016 Archives of trauma research

186. Robot Assisted Stereotactic Laser Ablation for a Radiosurgery Resistant Hypothalamic Hamartoma (PubMed)

. Recently, in children, stereotactic laser ablation has shown promise as a surgical technique that can combine the best features of both of these approaches for the treatment of HH. Here we present the first reported use of a frameless robot-assisted stereotactic system to treat an HH. The patient had failed two previous Gamma Knife radiosurgery treatments. Post-procedure he had a stable, but unintentional weight loss of 20 kg and a transient episode of hemiparesis the night of the operation. At six (...) Robot Assisted Stereotactic Laser Ablation for a Radiosurgery Resistant Hypothalamic Hamartoma Hypothalamic hamartomas (HH) are benign tumors that can cause significant morbidity in adults as a cause of epilepsy, particularly gelastic seizures. Open and endoscopic resections of HH offer good seizure control but have high rates of morbidity and are technically challenging. Stereotactic radiosurgery has been an alternative treatment; however, it results in comparably poor seizure control

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2016 Cureus

187. Hemophagocytic Lymphohistiocytosis in a Patient with Classical Hodgkin Lymphoma (PubMed)

clinicopathological features of HLH include fevers, cytopenias, hepatosplenomegaly, and hemophagocytosis in the bone marrow. Case Presentation. A previously healthy 28-year-old Caucasian male presented with a one-month history of persistent fever, night sweats, and unintentional weight loss. He was diagnosed with classical Hodgkin Lymphoma (HL) by core-needle biopsy of an axillary lymph node. Both bone marrow involvement by HL and hemophagocytosis were seen on subsequent bone marrow biopsy. Other findings (...) included pancytopenia, splenomegaly, and elevated serum ferritin. Extensive work-up for autoimmune and infectious etiologies was unremarkable. The patient had a complete response after chemotherapy with Adriamycin, bleomycin, vincristine, and dacarbazine. Conclusion. This report documents the exceedingly uncommon association between HLH and HL. HLH is a hyperinflammatory syndrome with high mortality, so it is imperative to identify and treat the underlying cause for secondary HLH. Malignancy-associated

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2016 Case reports in hematology

188. Comparing the Effectiveness of Two Dietary Interventions for Fecal Incontinence

: No Criteria Inclusion Criteria Experience at least 1 episode/week of unintentional loss of stool associated with diarrhea/loose stool (Bristol stool scale of 5 or greater). Subjects aged 18 and older meeting the Rome III criteria for Functional Fecal incontinence diagnostic criteria: Recurrent uncontrolled passage of fecal material in an individual and one or more of the following: Abnormal functioning of normally innervated and structurally intact muscles Minor abnormalities of sphincter structure (...) : December 11, 2018 See Sponsor: University of Michigan Collaborator: The Rome Foundation Information provided by (Responsible Party): Stacy Menees, University of Michigan Study Details Study Description Go to Brief Summary: Background: Fecal incontinence (FI) is a common complaint, and is often associated with diarrhea and urgency. Foods that are high in fermentable oligo-, di-, and mono-saccharides and polyols (FODMAPs) cause symptoms of diarrhea and urgency. Thus, assessing the impact of a low FODMAP

2016 Clinical Trials

189. Persistent Inflammation, Immunosuppression and Catabolism Syndrome (PICS): A New Horizon for Surgical Critical Care and Induced Frailty

vulnerable when they experience: muscle weakness fatigue low physical activity, and unintentional loss in body weight, which has been agreed upon by a consensus of experts. Two additional non-intravenous contrasted CT scans will be obtained at 3 and 12 months as part of the study protocol to assess for interval change in SMI/sarcopenia. Objective mobility and activity monitoring will be performed to supplement assessment of frailty and disability. Wearable monitors (similar in size and appearance (...) will be determined as a combination of factors. An older adult is considered physically vulnerable when they experience: muscle weakness fatigue low physical activity, and unintentional loss in body weight, which has been agreed upon by a consensus of experts. This will be collected at baseline, 3, 6 and 12 months. Other: Modified Minnesota Leisure Time Activities A questionnaire used to assess physical activity will be administered at baseline, 3, 6 and 12 months. Other: Computed tomography morphometrics A CT

2016 Clinical Trials

190. SGLT2 Inhibition and Left Ventricular Mass

episodes any condition prohibiting MRI studies (e.g. metal implants, claustrophobia, body weight too high) including any suspected reaction after contrast agent application patient actively attempted to lose weight or experienced unintentional clinically significant weight loss during the last 3 months bariatric surgery or other gastrointestinal surgery procedures that induce chronic malabsorption treatment with any weight loss drug in the preceding 6 months planned significant changes of pre-study (...) weight loss. Finally, intramyocardial lipids are associated with impaired diastolic function in patients with type 2 diabetes mellitus. Myocardial insulin resistance may also contribute to heart failure, because genetic deletion of cardiac insulin receptors in mice worsens catecholamine-mediated myocardial injury. Heart failure risk may be further exacerbated through obesity-induced neurohumoral activation and systemic inflammation. Inflammatory cytokines are elevated in heart failure and modulate

2016 Clinical Trials

191. The ENRGISE Pilot Study

will be characterized with Fried criteria developed by Fried et al. that employ self-reported exhaustion, unintentional weight loss, low energy expenditure, slow gait speed, and weak grip strength. Those with >3 of the 5 factors are judged to be frail, those with 1 or 2 factors as pre-frail, and those with no factors as non-frail. Changes in the isometric hand grip strength will be performed at baseline, months 3, 6, 9, and 12, between the groups [ Time Frame: Changes from baseline to months 3, 6, 9, and 12 (...) -Mental State Exam (MMSE) score <24 (<23 for racial/ethnic minorities or participants with less than 9 years of education) Unable to communicate because of severe hearing loss or speech disorder Neurological conditions that are causing impaired muscle function or mobility (may include stroke with residual paresis, paralysis, neuropathy, Parkinson disease, or multiple sclerosis) Severe rheumatologic or orthopedic diseases, e.g., awaiting joint replacement, known active inflammatory or autoimmune

2016 Clinical Trials

192. Combination of PCI-32765 With Obinutuzumab in Untreated Follicular Lymphoma

not suitable for radiotherapy, or stage II bulky disease Age ≥ 18 years No prior lymphoma therapy Need for start of therapy as defined by: bulky disease at study entry according to the GELF criteria (nodal or extranodal mass >7 cm in its greater diameter) and/or B symptoms (fever, drenching night sweats, or unintentional weight loss of >10% of normal body weight over a period of 6 months or less) and/or hematopoietic insufficiency (granulocytopenia < 1.500/µl, Hb < 10 g/dl, thrombocytopenia < 100.000/µl (...) Functional Classification pulmonary (e.g. chronic lung disease with hypoxemia) endocrine (e.g. severe, not sufficiently controlled diabetes mellitus) renal insufficiency (unless caused by the lymphoma): creatinine > 2x normal value and/or creatinine clearance < 50 ml/min) impairment of liver function (unless caused by the lymphoma): transaminases > 3x normal or bilirubin > 2,0 mg/dl (unless caused by known Morbus Meulengracht [Gilbert-Meulengracht-Syndrome]) Positive test results for chronic HBV

2016 Clinical Trials

193. Efficacy Study of Thalidomide in Gastrointestinal Vascular Malformation Related Bleeding

treatment or surgery; Any significant "alarm symptoms" within the past 6 months, such as, unintentional weight loss, signs of gastrointestinal bleeding more than 2 weeks prior to enrolment, jaundice, or any other sign indicating serious or malignant disease; Malignancy or clinically significant cardiovascular, pulmonary, renal, pancreatic, hepatic disease, cirrhotic or portal hypertension gastropathy, rheumatologic disorders, uncontrollable diabetes mellitus or hypertension as judged by the investigator (...) red protrusions, with surrounding venous dilatation or patchy erythema with or without oozing; Exclusion Criteria: Less than 1 year of bleeding history; GI bleeding caused by Esophageal varices, Mallory Weiss syndrome, Zollinger-Ellison syndrome, Suspicion of gastric malignancy at baseline endoscopy, Post-Billroth-resection, Biliary disorders, Gastrointestinal tumors, Crohn's disease or Ulcerative colitis, Hemangioma or unknown source of GI bleeding; Bleeding that needs emergent endoscopic

2016 Clinical Trials

194. Metastatic Colon Cancer in an 18-Year-Old without Predisposing Factors (PubMed)

appendicitis, the working diagnosis may be considered to be anorexia. This case illustrates the importance of considering colon cancer among other disease entities as a cause of unintentional weight loss in adolescents. While this is a rare occurrence in the pediatric population, significant unintentional weight loss with altered bowel habits should prompt a search for underlying malignancy-even in the absence of a positive family history or predisposing cancer syndromes. (...) Metastatic Colon Cancer in an 18-Year-Old without Predisposing Factors While colorectal carcinoma is a common gastrointestinal cancer in adults, it is rare in pediatrics with an incidence of 1 : 1,000,000 and represents a fraction of neoplasms encountered in children. Malignant neoplasms represent a major cause of mortality in the pediatric age group. While presenting with weight loss, iron deficiency, rectal bleeding, abdominal pain, and change in bowel habits, or symptoms similar to acute

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2016 Case reports in pediatrics

195. Frailty and Mortality in Older Old With Severe Aortic Stenosis

, physical activity, fatigue, unintentional weight loss) and determination of inflammatory markers (C-reactive protein and interleukin-6). During follow-up, measures of functional impairment (basic and instrumental activities of daily living, walking speed and timed set up & go test), hospitalizations, death and quality of life will be determined. Condition or disease Intervention/treatment Aortic Stenosis Other: Frailty measurement Other: Comprehensive Geriatric Assessment Study Design Go to Layout (...) Pascual, Hospital de Meixoeiro Study Details Study Description Go to Brief Summary: BACKGROUND.- The frailty syndrome (FS) associates an increase in morbidity and mortality in the elderly patient. When severe and symptomatic, aortic stenosis (AS) is a disease with poor prognosis, the most frequent cause of heart surgery in the elderly and associates high health costs. No variables have been identified as determinants of morbidity and mortality of these patients and there are not algorithms developed

2016 Clinical Trials

196. Patient Modesty: Volume 74

the patient should have the primary interest and concern which then includes all matters of modesty? The physician's "needs", such as facilitation of time spent with the patient, assistance by others (which might include gender other than that of the patient) during interaction with the patient or other physician professional but self-interest demands, should bear far less weight on balance than the patient's modesty needs. On the other hand, shouldn't the goal be an attempt to balance the "needs (...) a small penalty, the loss of 5 percent of prison-related federal grants, if they opt out of the process entirely. There are a lot of carrots in PREA, and not enough sticks. Texas’ opting out was considered especially significant, however, because it has the largest prison population in the country and by far the most reports of sexual assault and abuse. Texas had three and a half times as many allegations as California in 2011, when California still had more inmates than Texas (according

2016 Bioethics Discussion Blog

197. Association Between Anthropometric Measures and Long-Term Survival in Frail Older Women: Observations from the Women's Health Initiative Study. (PubMed)

or excluding women with early death and unintentional weight loss did not substantially change these findings.In frail, older women, having a BMI between 25.0 and 34.9 kg/m(2) or a WHR of 0.8 or less was associated with lower mortality. Currently recommended healthy BMI guidelines should be reevaluated for frail older women.© 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society. (...) Association Between Anthropometric Measures and Long-Term Survival in Frail Older Women: Observations from the Women's Health Initiative Study. To evaluate the association between currently recommended guidelines and commonly used clinical criteria for body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) and all-cause mortality in frail older women.Longitudinal prospective cohort study.Women's Health Initiative (WHI)-Observational Study.A sample of women aged 65-84

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2016 Journal of the American Geriatrics Society

198. Elevated Plasma Vitamin B12 Concentrations Are Independent Predictors of In-Hospital Mortality in Adult Patients at Nutritional Risk (PubMed)

was 2.20 (95% CI, 1.56-3.08; p < 0.001); it was independent of age, gender, body mass index, six-month previous unintentional weight loss, admission ward, presence of malignancy, renal function, C-reactive protein and prealbumin. Patients with high vitamin B12 also had a longer length of stay (LOS) than those with normal concentrations (median 25 days, (IQR 15-41) versus 23 days (IQR 14-36); p = 0.014), and elevated vitamin B12 was an independent predictor of LOS (p = 0.027). Conclusions (...) : An independent association between elevated vitamin B12 concentrations, mortality and LOS was found in our sample of hospitalized adult patients at nutritional risk. Although the underlying mechanisms are still unknown and any cause-effect relation cannot be inferred, clinicians should be aware of the potential negative impact of high vitamin B12 concentrations in hospitalized patients at nutritional risk and avoid inappropriate vitamin supplementation.

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2016 Nutrients

199. Defining malnutrition: A plea to rethink. (PubMed)

Defining malnutrition: A plea to rethink. In a recent consensus report in Clinical Nutrition the undernourished category of malnutrition was proposed to be defined and diagnosed on the basis of a low BMI or unintentional weight loss combined with low BMI or FFMI with certain cut off points. The definition was endorsed by ESPEN despite recent endorsement of a very different definition. The approach aims to assess whether nutritional intake is sufficient but is imprecise because a low BMI does (...) of nutritional intake without knowing the impact of inflammation. Most importantly, functional abilities are not assessed. Consequently it will remain uncertain how well the individual can overcome stressful events, what the causes are of dysfunction, how to set priorities for treatment and how to predict the effect of nutritional support. We therefore advise to consider the pathophysiology of malnourished individuals leading to inclusion of the following elements in the definition of malnutrition

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2016 Clinical nutrition (Edinburgh, Scotland)

200. Are changes in routine health behaviours the missing link between bereavement and poor physical and mental health?

and frequency of tobacco use was assessed using self-report. There was inconsistent evidence for the impact of bereavement on smoking behaviour, with bereavement reducing smoking frequency among current smokers (particularly men) but increasing the likelihood of smoking initiation among female non-smokers. Weight status 6 studies: 1 cross-sectional, 5 prospective longitudinal, 0 post-bereavement longitudinal There was consistent evidence across the studies that bereavement led to unintentional weight loss (...) for changes in nutrition, sleep quality and weight status after bereavement Moderate evidence for an impact on alcohol consumption Mixed evidence for effects on physical activity and tobacco use Although this review did not explore why bereavement led to these changes in health behaviours, the authors provide a number of explanations, which should be examined in future studies: Loss of social support and the onset of depression and grief. This may reduce motivation to engage in health-promoting behaviours

2015 The Mental Elf

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