Communication and the Pragmatic Condition

Presented March 9, 201

Nutritional support in cancer patients: A position paper from the Italian Society of Medical Oncology (AIOM) and the Italian Society of Artificial Nutrition and Metabolism (SINPE)

Malnutrition is a frequent problem in cancer patients, which leads to prolonged hospitalization, a higher degree of treatment-related toxicity, reduced response to cancer treatment, impaired quality of life and a worse overall prognosis. The attitude towards this issue varies considerably and many malnourished patients receive inadequate nutritional support. We reviewed available data present in the literature, together with the guidelines issued by scientific societies and health authorities, on the nutritional management of patients with cancer, in order to make suitable and concise practical recommendations for appropriate nutritional support in this patient population. Evidence from the literature suggests that nutritional screening should be performed using validated tools (the Nutritional Risk Screening 2002 [NRS 2002], the Malnutrition Universal Screening Tool [MUST], the Malnutrition Screening Tool [MST] and the Mini Nutritional Assessment [MNA]), both at diagnosis and at regular time points during the course of disease according to tumor type, stage and treatment. Patients at nutritional risk should be promptly referred for comprehensive nutritional assessment and support to clinical nutrition services or medical personnel with documented skills in clinical nutrition, specifically for cancer patients. Nutritional intervention should be actively managed and targeted for each patient; it should comprise personalized dietary counseling and/or artificial nutrition according to spontaneous food intake, tolerance and effectiveness. Nutritional support may be integrated into palliative care programs. "Alternative hypocaloric anti-cancer diets" (e.g. macrobiotic or vegan diets) should not be recommended as they may worsen nutritional status. Well-designed clinical trials are needed to further our knowledge of the nutritional support required in different care settings for cancer patients

Altered Food Behavior and Cancer: A Systematic Review of the Literature

: There is evidence of an association between cancer and certain types of altered eating behaviors, including orthorexia, food cravings, and food addiction. Given the growing interest in the topic throughout the scientific community we conducted a systematic review to summarize current evidence on the development of altered food behavior, including food addiction and cancer. The Cochrane Collaboration and the Meta-analysis Of Observational Studies in Epidemiology guidelines were followed to perform this systematic review. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was used to report the process and results. The structured literature search was conducted on 19 April 2022, on PubMed/Medline and Scopus, combining free-text terms and medical subject headings. A total of seven articles were included once the selection process was completed. Food craving has been associated with different types of cancer in adults and young patients, as well as with orthorexia; conversely, compulsive eating has only been explored in patients with prolactinoma treated with dopamine agonists. This systematic review explored a new area of research that warrants further investigation. More research is required to better understand the relationship between cancer and food behavior

Molecular phylogenetic relationships among some stygobiotic cirolanid species (Crustacea, Isopoda)

Within the Cirolanidae, a widespread family of marine isopods, about 23 genera are stygobitic and inhabit phreatic and anchialine ecosystems, with many endemic species. The Mediterranean area has a high biodiversity of subterranean cirolanids, which are considered thalassoid limnostygobionts. A molecular analysis was conducted using mtDNA genes to infer the phylogeny of species belonging to six of the seven stygobitic genera of Cirolanidae inhabiting the Mediterranean basin and to two American taxa: Faucheria faucheri, Marocolana delamarei, Saharolana seurati, Sphaeromides virei virei, Turcolana sp., 13 taxa of the genus Typhlocirolana and two American species, Antrolana lira and Speocirolana bolivari. The Typhlocirolana species are widespread in the western Mediterranean basin, with a concentration of taxa in the Maghreb region. Turcolana sp. is localised in the eastern Mediterranean, while F. faucheri and S. v. virei are north Mediterranean taxa. S. seurati, the taxon least morphologically adapted to subterranean life, belongs to a monospecific genus present in a Tunisian spring. The molecular phylogeny showed a high affinity among the American taxa and the Mediterranean Sphaeromides, clustering in the Sphaeromides group identified by previous morphological studies. Typhlocirolana species and M. delamarei constitute their sister clade within the Sphaeromides group. F. faucheri appears to be a sister clade of the Sphaeromides group. S. seurati, showing reduced troglobitic adaptations, assumes disparate and unsolved positions in the phylogenetic reconstructions. The molecular data suggest that a combination of vicariance and dispersal events, occurring from 180 to a few million years ago, combined to bring about the present distribution pattern of Mediterranean cirolanid isopods

TPN nell'insufficienza epatica

cirrosi epatic

Artificial nutrition in anorexia nervosa

In view of the paucity of studies and recognized difficulties in conducting randomized clinical trials in anorexia nervosa, evidence-based guidelines for enteral and parenteral nutrition in these patients are lacking, and current recommendations are based on experts\u2019 opinions. After reviewing available studies on this topic, we\u2019ll attempt to outline practice recommendations for artificial nutrition in anorexia nervosa. Although criteria for the use of artificial nutrition and its management vary among countries and among different centres for eating disorders, a consensus prevails that enteral nutrition should be resorted to when oral feeding fails especially in critical situations (as a life-saving intervention), while parenteral nutrition should be considered only for patients with impaired intestinal function. Both available studies and clinical experience support the effectiveness of enteral nutrition on weight restoration. When enteral nutrition is integrated in a multimodal approach (nutritional and psychotherapeutic), and managed by an expert team, patients\u2019 acceptance and compliance to nasogastric feeding are satisfactory, and major complications, such as the refeeding syndrome, may be avoided. However, it is essential that every team involved in treatment of eating disorders develop standard criteria and procedures for its use