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Identifier |
000369354 |
Title |
Εκτίμηση της κατάστασης της θρέψης σε ασθενείς με καρκίνο του πνεύμονα με την εφαρμογή του πρωτοκόλλου Mini Nutritional Assessment (MNA) : συσχέτιση με κλινικοεργαστηριακές παραμέτρους υποθρεψίας-καχεξίας και με την επιβίωση |
Alternative Title |
Evaluation nutritional status in patients with lung cancer with the MNA protocol: correlation with clinico-laboratory parameters related with malnutrition-cachexia and with survival |
Author
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Γκιουλμπασάνης, Ιωάννης Γ
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Thesis advisor
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Μαυρουδής, Δ.
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Reviewer
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Γεωργούλιας, Βασίλης
Μαργιωρής, Α.
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Abstract |
Cancer cachexia syndrome frequently accompanies lung cancer and is
related with increased morbidity and adverse prognosis. The syndrome is
characterized by loss of muscle mass with or without loss of fat tissue as a
consequence of an underline disease. Cytokines seem to play a major
pathophysiologic role as they modify orexiogenic signals, they influence
energy balance and they stimulate muscle degradation as well as fat loss.
In its early stage, when the syndrome is theoretically reversible,
usually it does not provoke clinical suspicion. On the other part of the
spectrum, when the syndrome is fully established, any intervention might be
not only ineffective but also futile. Sarcopenic obesity is another
confounding factor which masks syndrome’s timely diagnosis as muscle loss
occurs under a layer of fat.
Till now, diagnosis of the syndrome is based solely on the
quantification of weight loss. However, and besides the lack of agreement
among physicians on the exact percentage of weight loss and the time
period in which this should occur, this method of nutritional assessment
represents a rather oversimplified approach. On the other hand, an in-depth
nutritional evaluation performed by a registered dietitian is time
consuming, costly, requires specialized equipment and, thus, could not
applied routinely. Screening questionnaires like the Mini Nutritional
Assessment (MNA), originally developed for elderly patients with non
malignant diseases, have been proposed as a more accurate nutritional
assessment.
In the present study MNA was validated and compared against the
weight loss history in patients with metastatic lung cancer. MNA identifies
more patients as candidates for nutritional support and outperforms weight
loss in terms of its correlation with clinico-laboratory related with
malnutrition, response to antineoplastic therapy and prognosis. Despite the
fact that MNA is a geriatric protocol, its prognostic value was also
demonstrated in the subgroup of non-elderly patients. Interestingly,
according to MNA, more than 50% of the obese patients were at nutritional
risk and, thus, they should be referred for nutritional support.
In the present study MNA was validated in metastatic lung cancer
patients, and based on our results could be used for the nutritional
evaluation in this population. Moreover, it is possible to consider MNA as a
new standard method against which any proposed nutritional assessment
tool could be tested.
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Language |
Greek |
Subject |
Cachexia |
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Lung cancer |
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Neoplasms diet therapy |
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Nutrition Therapy |
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Nutritional assessment |
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Weight loss |
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Απώλεια βάρους |
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Καρκίνος πνεύμονα |
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Κατάσταση της θρέψης |
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Καχεξία |
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ΜΝΑ |
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Νεοπλάσματα Διαιτοθεραπεία |
Issue date |
2011-07-15 |
Collection
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School/Department--School of Medicine--Department of Medicine--Doctoral theses
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Type of Work--Doctoral theses
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Permanent Link |
https://elocus.lib.uoc.gr//dlib/5/e/e/metadata-dlib-6vlf02k7pkb2bidgc9ka1re7c6_1318932689.tkl
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Views |
305 |