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  1. Buch: Nutrition and the cancer patient

    Del Fabbro, Egidio

    2010  

    Verfasserangabe ed. by Egidio Del Fabbro
    Sprache Englisch
    Umfang XIV, 519 S. : Ill., graph. Darst., 25 cm
    Verlag Oxford Univ. Press
    Erscheinungsort Oxford u.a.
    Erscheinungsland Vereinigtes Königreich
    Dokumenttyp Buch
    HBZ-ID HT016364631
    ISBN 978-0-19-955019-7 ; 0-19-955019-0
    Datenquelle Katalog ZB MED Ernährung, Umwelt, Agrar

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    Verfügbar in ZB MED Bonn

    SignaturLeihstatusStandort
    104/398 ausleihbar (Lesesaal) Freihandmagazin (U1)

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  2. Buch: Nutrition and the cancer patient

    Del Fabbro, Egidio

    2010  

    Verfasserangabe ed. by Egidio Del Fabbro
    Sprache Englisch
    Umfang XIV, 519 S. : Ill., graph. Darst., 25 cm
    Verlag Oxford Univ. Press
    Erscheinungsort Oxford u.a.
    Erscheinungsland Vereinigtes Königreich
    Dokumenttyp Buch
    HBZ-ID HT016364631
    ISBN 978-0-19-955019-7 ; 0-19-955019-0
    Datenquelle Katalog ZB MED Medizin, Gesundheit

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    Verfügbar in ZB MED Köln/Königswinter

    SignaturLeihstatusStandort
    2010 A 3705 bestellbar zur Ausleihe Magazin

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  3. Artikel ; Online: Improving the perception of physician compassion, communication skills, and professionalism in the outpatient clinic.

    Del Fabbro, Egidio

    Cancer

    2021  Band 127, Heft 21, Seite(n) 3924–3925

    Mesh-Begriff(e) Ambulatory Care Facilities ; Communication ; Empathy ; Humans ; Perception ; Physician-Patient Relations ; Physicians ; Professionalism
    Sprache Englisch
    Erscheinungsdatum 2021-07-15
    Erscheinungsland United States
    Dokumenttyp Editorial ; Research Support, N.I.H., Extramural ; Comment
    ZDB-ID 1429-1
    ISSN 1097-0142 ; 0008-543X ; 1934-662X
    ISSN (online) 1097-0142
    ISSN 0008-543X ; 1934-662X
    DOI 10.1002/cncr.33776
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

    Volltext online

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    Verfügbar in ZB MED Köln/Königswinter

    Uh III Zs.146: Hefte anzeigen Standort:
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  4. Artikel ; Online: Hepatocellular carcinoma and sarcopenia: a narrative review.

    Revoredo, Stephanie / Del Fabbro, Egidio

    Annals of palliative medicine

    2023  Band 12, Heft 6, Seite(n) 1295–1309

    Abstract: Background and objective: Hepatocellular carcinoma (HCC) affects millions of people each year and is associated with high mortality and morbidity. Sarcopenia, a condition of muscle wasting, and decreased muscle performance is common among aging adults, ... ...

    Abstract Background and objective: Hepatocellular carcinoma (HCC) affects millions of people each year and is associated with high mortality and morbidity. Sarcopenia, a condition of muscle wasting, and decreased muscle performance is common among aging adults, and is associated with poor clinical outcomes. Individuals with HCC and chronic liver disease (CLD) are at high risk of sarcopenia because of the adverse effects of chronic inflammation, endocrine dysfunction, and hyperammonemia on muscle metabolism and adequate nutrition. Our aim is to review the clinical relationship between HCC and sarcopenia, and the assessment and management of these patients.
    Methods: A narrative review based on a literature search using PubMed. Keywords related to HCC and sarcopenia were used to identify relevant articles, primarily those published 2018-2023. The information was synthesized to provide a narrative review focused on the most recent literature.
    Key content and findings: Sarcopenia frequently co-exists with HCC and increases risk for adverse clinical outcomes such as symptom burden, quality of life (QoL), survival, and side effects of antineoplastic therapy. Tools are available to screen, assess and manage patients with HCC, and although there is no specific pharmacologic agent approved for sarcopenia in the United States, multimodal therapy is feasible in daily practice. Comprehensive management by an interdisciplinary team should include nutritional counseling, an exercise regimen and control of symptoms affecting nutrition and function.
    Conclusions: Sarcopenia has adverse effects on prognosis and tolerability of surgical and medical therapy in HCC. Patients with CLD and/or HCC would benefit from early identification, assessment, and therapeutic intervention. Management should be comprehensive, interdisciplinary, and include both pharmacologic and non-pharmacologic treatments. Further research is needed to identify individual agents that may mitigate muscle wasting and trials are needed to evaluate the benefit of multimodal therapy in HCC.
    Mesh-Begriff(e) Adult ; Humans ; Carcinoma, Hepatocellular/complications ; Carcinoma, Hepatocellular/therapy ; Sarcopenia/diagnosis ; Quality of Life ; Liver Neoplasms/complications ; Liver Neoplasms/therapy ; Prognosis
    Sprache Englisch
    Erscheinungsdatum 2023-10-16
    Erscheinungsland China
    Dokumenttyp Review ; Journal Article
    ZDB-ID 2828544-X
    ISSN 2224-5839 ; 2224-5839
    ISSN (online) 2224-5839
    ISSN 2224-5839
    DOI 10.21037/apm-23-332
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  5. Artikel: Updates in Cancer Cachexia: Clinical Management and Pharmacologic Interventions.

    Pandey, Sudeep / Bradley, Lauren / Del Fabbro, Egidio

    Cancers

    2024  Band 16, Heft 9

    Abstract: Despite a better understanding of the mechanisms causing cancer cachexia (CC) and development of promising pharmacologic and supportive care interventions, CC persists as an underdiagnosed and undertreated condition. CC contributes to fatigue, poor ... ...

    Abstract Despite a better understanding of the mechanisms causing cancer cachexia (CC) and development of promising pharmacologic and supportive care interventions, CC persists as an underdiagnosed and undertreated condition. CC contributes to fatigue, poor quality of life, functional impairment, increases treatment related toxicity, and reduces survival. The core elements of CC such as weight loss and poor appetite should be identified early. Currently, addressing contributing conditions (hypothyroidism, hypogonadism, and adrenal insufficiency), managing nutrition impact symptoms leading to decreased oral intake (nausea, constipation, dysgeusia, stomatitis, mucositis, pain, fatigue, depressed mood, or anxiety), and the addition of pharmacologic agents when appropriate (progesterone analog, corticosteroids, and olanzapine) is recommended. In Japan, the clinical practice has changed based on the availability of Anamorelin, a ghrelin receptor agonist that improved lean body mass, weight, and appetite-related quality of life (QoL) compared to a placebo, in phase III trials. Other promising therapeutic agents currently in trials include Espindolol, a non-selective β blocker and a monoclonal antibody to GDF-15. In the future, a single therapeutic agent or perhaps multiple medications targeting the various mechanisms of CC may prove to be an effective strategy. Ideally, these medications should be incorporated into a multimodal interdisciplinary approach that includes exercise and nutrition.
    Sprache Englisch
    Erscheinungsdatum 2024-04-27
    Erscheinungsland Switzerland
    Dokumenttyp Journal Article ; Review
    ZDB-ID 2527080-1
    ISSN 2072-6694
    ISSN 2072-6694
    DOI 10.3390/cancers16091696
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  6. Artikel ; Online: Should Urine Drug Screen be Done Universally or Selectively in Palliative Care Patients on Opioids?

    Arthur, Joseph / Childers, Julie / Del Fabbro, Egidio

    Journal of pain and symptom management

    2023  Band 66, Heft 6, Seite(n) e687–e692

    Abstract: Urine drug screen (UDS) is a useful test conducted in patients receiving opioids for chronic pain to aid in validating patient adherence to opioid treatment and to detect any nonmedical opioid use (NMOU). One controversial topic regarding its use in ... ...

    Abstract Urine drug screen (UDS) is a useful test conducted in patients receiving opioids for chronic pain to aid in validating patient adherence to opioid treatment and to detect any nonmedical opioid use (NMOU). One controversial topic regarding its use in palliative care is whether to conduct the test universally and randomly in all patients who are receiving opioids for chronic pain irrespective of their level of risk for NMOU, or to conduct the test selectively in only those with a high risk for engaging in NMOU behaviors. In this "Controversies in Palliative Care" article, 3 expert clinicians independently answer this question. Specifically, each expert provides a synopsis of the key studies that inform their thought processes, share practical advice on their clinical approach, and highlight the opportunities for future research. They all agreed that UDS has some utility in routine palliative care practice but acknowledged the insufficient existing evidence supporting its efficacy. They also underscored the need to improve clinician proficiency in UDS interpretation to enhance its utility. Two experts endorsed random UDS in all patients receiving opioids regardless of their risk profile while the other expert recommended targeted UDS until there is more clinical evidence to support universal, random testing. Use of more methodologically robust study designs in UDS research, examination of the cost-effectiveness of UDS tests, development of innovative programs to manage NMOU behaviors, and investigation of the impact of improved clinician proficiency in UDS interpretation on clinical outcomes, were important areas of future research that the experts identified.
    Mesh-Begriff(e) Humans ; Analgesics, Opioid/therapeutic use ; Chronic Pain/drug therapy ; Palliative Care ; Opioid-Related Disorders/therapy ; Opioid-Related Disorders/drug therapy ; Substance Abuse Detection
    Chemische Substanzen Analgesics, Opioid
    Sprache Englisch
    Erscheinungsdatum 2023-07-08
    Erscheinungsland United States
    Dokumenttyp Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 639142-4
    ISSN 1873-6513 ; 0885-3924
    ISSN (online) 1873-6513
    ISSN 0885-3924
    DOI 10.1016/j.jpainsymman.2023.06.033
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

    Volltext online

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    Verfügbar in ZB MED Köln/Königswinter

    Zs.A 2252: Hefte anzeigen Standort:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  7. Artikel ; Online: Combination therapy in cachexia.

    Del Fabbro, Egidio

    Annals of palliative medicine

    2018  Band 8, Heft 1, Seite(n) 59–66

    Abstract: Since Cancer cachexia is defined as a "multifactorial syndrome", an effective therapeutic approach might be comprehensive multi-faceted treatment that targets different pathophysiological mechanisms simultaneously. The defining features of cancer ... ...

    Abstract Since Cancer cachexia is defined as a "multifactorial syndrome", an effective therapeutic approach might be comprehensive multi-faceted treatment that targets different pathophysiological mechanisms simultaneously. The defining features of cancer cachexia, such as weight loss, reduced food intake, and chronic inflammation, might provide both a framework for classification of cachexia and a rationale for identifying multiple therapeutic targets. Past efforts to treat cachexia with nutritional or medical interventions may have disappointed because they were directed at a single domain of the syndrome, such as anorexia or muscle wasting, usually with a single therapeutic agent. Preliminary trials combining pharmacological and non-pharmacological therapy have been shown to be feasible and also to improve selected clinical outcomes. The choice of specific pharmacological agents has varied based on mechanistic considerations or on prior promising single intervention or multimodal trials. Despite the variations in therapy composition, most multimodal regimens share a common purpose in simultaneously modulating the major mechanisms causing cachexia, identifying patients early in the illness trajectory, and including supportive care measures such as symptom management, exercise, and nutritional counseling/supplementation.
    Mesh-Begriff(e) Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; Cachexia/etiology ; Cachexia/therapy ; Combined Modality Therapy/methods ; Counseling/methods ; Dietary Supplements ; Drug Therapy, Combination ; Exercise Therapy/methods ; Fatty Acids, Omega-3/therapeutic use ; Humans ; Neoplasms/complications ; Nutritional Support ; Patient Preference ; Psychosocial Support Systems
    Chemische Substanzen Anti-Inflammatory Agents, Non-Steroidal ; Fatty Acids, Omega-3
    Sprache Englisch
    Erscheinungsdatum 2018-08-27
    Erscheinungsland China
    Dokumenttyp Journal Article ; Review
    ZDB-ID 2828544-X
    ISSN 2224-5839 ; 2224-5820
    ISSN (online) 2224-5839
    ISSN 2224-5820
    DOI 10.21037/apm.2018.08.05
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  8. Artikel: Managing Nutrition Impact Symptoms in Cancer Cachexia: A Case Series and Mini Review.

    Khorasanchi, Adam / Nemani, Srinidhi / Pandey, Sudeep / Del Fabbro, Egidio

    Frontiers in nutrition

    2022  Band 9, Seite(n) 831934

    Abstract: Malnutrition is common in cancer patients and can occur throughout a patient's disease course. The contributors to the clinical syndrome of cancer cachexia are often multifactorial, and produced by the cancer and associated pro-inflammatory response. ... ...

    Abstract Malnutrition is common in cancer patients and can occur throughout a patient's disease course. The contributors to the clinical syndrome of cancer cachexia are often multifactorial, and produced by the cancer and associated pro-inflammatory response. Since cancer cachexia is a multifactorial syndrome, a multimodal therapeutic approach is ideal. A key component of therapy is identifying and managing symptom barriers to adequate oral intake, known as nutritional impact symptoms (NIS). NIS are associated with reduced intake and weight loss in patients with advanced cancer, and aggregate NIS are a predictor of survival in patients with Head and Neck Cancer and in patients undergoing surgery for esophageal cancer. Currently, there are no guidelines regarding the specific management of NIS in oncology patients. Experience from specialist centers suggest relatively simple assessments and inexpensive interventions are available for the diagnosis and treatment of NIS. We present three patient cases from a cachexia clinic, where NIS management decreased symptom burden and improved clinical outcomes such as weight and physical performance.
    Sprache Englisch
    Erscheinungsdatum 2022-03-03
    Erscheinungsland Switzerland
    Dokumenttyp Journal Article ; Review
    ZDB-ID 2776676-7
    ISSN 2296-861X
    ISSN 2296-861X
    DOI 10.3389/fnut.2022.831934
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  9. Artikel ; Online: Best Practices in the Management of Nonmedical Opioid Use in Patients with Cancer-Related Pain.

    Ulker, Esad / Del Fabbro, Egidio

    The oncologist

    2019  Band 25, Heft 3, Seite(n) 189–196

    Abstract: Introduction: Nonmedical opioid use (NMOU) in patients with cancer is a term covering a spectrum of nonprescribed opioid use. The extent to which an individual uses opioids in a nonprescribed manner will influence propensity for adverse effects such as ... ...

    Abstract Introduction: Nonmedical opioid use (NMOU) in patients with cancer is a term covering a spectrum of nonprescribed opioid use. The extent to which an individual uses opioids in a nonprescribed manner will influence propensity for adverse effects such as neurotoxicity, substance use disorder, overdose, and death.
    Objectives: The objectives of this study were to (A) evaluate current literature regarding management of NMOU in patients with cancer-related pain; (B) provide best practice recommendations based on evidence; and (C) integrate practices derived from the management of noncancer pain, where clinically appropriate or when the oncology literature is limited.
    Methods: This study is a narrative review.
    Implications: Although harm from NMOU was thought to be rare among oncology patients, about one in five patients with cancer is at risk of adverse outcomes including prolonged opioid use, high opioid doses, and increased health care utilization. The management of NMOU can be challenging because pain is a multidimensional experience encompassing physical, psychological, and spiritual domains. An interdisciplinary team approach is most effective, and management strategies may include (A) education of patients and families; (B) harm reduction, including opioid switching, decreasing the overall daily dose, avoiding concurrent sedative use, and using adjuvant medications for their opioid-sparing potential; (C) managing psychological and spiritual distress with an interdisciplinary team and techniques such as brief motivational interviewing; and (D) risk mitigation by pill counts, frequent clinic visits, and accessing statewide prescription drug monitoring plans.
    Conclusion: Although many of the management strategies for NMOU in patients with cancer-related pain are modeled on those for chronic non-cancer-related pain, there is emerging evidence that education and harm-reduction initiatives specifically for cancer-related pain are effective.
    Implications for practice: Nonmedical opioid use (NMOU) in patients with cancer is a term covering a broad spectrum of nonprescribed opioid use. The extent to which an individual uses opioids in a nonprescribed manner will influence propensity for adverse effects such as neurotoxicity, substance use disorder, overdose, and death. This review evaluates the evidence for best practices in oncology and addresses limitations in the literature with supplemental evidence from noncancer chronic pain. Management recommendations for NMOU are provided, based on a combination of literature-based evidence and best clinical practice. Effective management of NMOU in oncology has the potential to improve quality of life, decrease health utilization, and improve survival.
    Mesh-Begriff(e) Analgesics, Opioid/adverse effects ; Cancer Pain/drug therapy ; Chronic Pain/drug therapy ; Humans ; Neoplasms/complications ; Neoplasms/drug therapy ; Opioid-Related Disorders/drug therapy ; Opioid-Related Disorders/epidemiology ; Quality of Life
    Chemische Substanzen Analgesics, Opioid
    Sprache Englisch
    Erscheinungsdatum 2019-12-24
    Erscheinungsland United States
    Dokumenttyp Journal Article ; Review
    ZDB-ID 1409038-7
    ISSN 1549-490X ; 1083-7159
    ISSN (online) 1549-490X
    ISSN 1083-7159
    DOI 10.1634/theoncologist.2019-0540
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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    Verfügbar in ZB MED Köln/Königswinter

    Zs.A 4845: Hefte anzeigen Standort:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 494: Hefte anzeigen

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  10. Artikel ; Online: Pain Management in the Era of the Opioid Crisis.

    Bruera, Eduardo / Del Fabbro, Egidio

    American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting

    2018  Band 38, Seite(n) 807–812

    Abstract: PRACTICAL APPLICATIONS Recognize patients at higher risk for nonmedical opioid use. Learn about screening for chemical coping risk. Diagnose nonmedical opioid use. Manage nonmedical opioid use in the clinical oncology setting. Understand clinical ... ...

    Abstract PRACTICAL APPLICATIONS Recognize patients at higher risk for nonmedical opioid use. Learn about screening for chemical coping risk. Diagnose nonmedical opioid use. Manage nonmedical opioid use in the clinical oncology setting. Understand clinical criteria for referral to supportive and palliative care teams.
    Mesh-Begriff(e) Analgesics, Opioid/administration & dosage ; Analgesics, Opioid/adverse effects ; Analgesics, Opioid/therapeutic use ; Biomarkers ; Cancer Pain/diagnosis ; Cancer Pain/etiology ; Cancer Pain/metabolism ; Cancer Pain/therapy ; Humans ; Opioid-Related Disorders ; Pain Management ; Pain Measurement ; Pain Perception/drug effects ; Practice Patterns, Physicians' ; Signal Transduction/drug effects ; Treatment Outcome
    Chemische Substanzen Analgesics, Opioid ; Biomarkers
    Sprache Englisch
    Erscheinungsdatum 2018-09-19
    Erscheinungsland United States
    Dokumenttyp Journal Article ; Review
    ISSN 1548-8756 ; 1092-9118 ; 1548-8748
    ISSN (online) 1548-8756
    ISSN 1092-9118 ; 1548-8748
    DOI 10.1200/EDBK_208563
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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