Effektivität eines patientenzentrierten Stationssettings für Demenzpatienten mit internistischen Erkrankungen:eine empirische Verlaufsstudie

Anhand empirischer Daten aus dem Jahre 1997 der Station Franziskus, Geriatrie-Zentrum Haus Berge, Elisabeth Krankenhaus Essen, wird diskutiert, welche Bedeutung einem patientenzentrierten, an die besonderen Verhältnisse dementer Patienten ausgerichteten Stations-Setting in der internistischen Diagnostik und Therapie zukommt. Nur die patientenorientierte Kooperation zwischen Geriatrie und Gerontopsychiatrie kann eine optimale Betreuung internistisch erkrankter Dementer bewirken. Unter paralleler Therapie von Demenz und internistischer Begleiterkrankung kommt es zu einer signifikanten Verbesserung der Selbstständigkeit in den Aktivitäten des täglichen Lebens (ADL). Eine klinisch relevante Besserung zeigte sich unter Festlegung eines Responderkriteriums bei 76.3 % der Betroffenen. Der Schweregrad der Demenz (gemäß GDS) zeigte bei 64 % der Patienten eine Verbesserung unterschiedlicher Ausprägung

Pilot clinical trial of macimorelin to assess safety and efficacy in patients with cancer cachexia

Abstract Background Cancer cachexia is associated with reduced body weight, appetite and quality of life (QOL) with no approved treatments. Growth hormone secretagogues like macimorelin have potential to mitigate these effects. Methods This pilot study assessed the safety and efficacy of macimorelin for 1 week. Efficacy was defined a priori as 1‐week change in body weight (≥0.8 kg), plasma insulin‐like growth factor (IGF)‐1 (≥50 ng/mL) or QOL (≥15%). Secondary outcomes included food intake, appetite, functional performance, energy expenditure and safety laboratory parameters. Patients with cancer cachexia were randomized to 0.5 or 1.0 mg/kg macimorelin or placebo; outcomes were assessed non‐parametrically. Results Participants receiving at least one of either macimorelin dose were combined (N = 10; 100% male; median age = 65.50 ± 2.12) and compared with placebo (N = 5; 80% male; median age = 68.00 ± 6.19). Efficacy criteria achieved: body weight (macimorelin N = 2; placebo N = 0; P = 0.92); IGF‐1 (macimorelin N = 0; placebo N = 0); QOL by Anderson Symptom Assessment Scale (macimorelin N = 4; placebo N = 1; P = 1.00) or Functional Assessment of Chronic Illness Therapy‐Fatigue (FACIT‐F; macimorelin N = 3; placebo N = 0; P = 0.50). No related serious or non‐serious adverse events were reported. In macimorelin recipients, change in FACIT‐F was directly associated with change in body weight (r = 0.92, P = 0.001), IGF‐1 (r = 0.80, P = 0.01), and caloric intake (r = 0.83, P = 0.005), and inversely associated with change in energy expenditure (r = −0.67, P = 0.05). Conclusions Daily oral macimorelin for 1 week was safe and numerically improved body weight and QOL in patients with cancer cachexia compared with placebo. Longer term administration should be evaluated for mitigation of cancer‐induced reductions in body weight, appetite and QOL in larger studies

Make EU trade with Brazil sustainable

Brazil, home to one of the planet's last great forests, is currently in trade negotiations with its second largest trading partner, the European Union (EU). We urge the EU to seize this critical opportunity to ensure that Brazil protects human rights and the environment