Nutrition of patients during radio and chemotherapy

The most common method of cancer treatment still includes surgical treatment, which is also the oldest way to fight cancer. Radiotherapy is currently one of the basic method of treating malignant tumors [1]. This method uses the action of ionizing radiation. However, the radiation does not work selectively and also damages healthy tissues. Chemotherapy - the youngest method of cancer treatment - consists in administering to patients cytostatics that block the basic life functions of the cell, mainly by disrupting the ability to divide and multiply cancer cells. Each of the mentioned therapeutic methods may cause side effects in addition to the therapeutic effect. Anorexia, vomiting, nausea and diarrhea or constipation are most often observed. During radiotherapy and chemotherapy, patients observe changes in taste, dry mouth and the possibility of oral irritation [2]. Through the occurrence of side effects of radio and chemotherapy, patients are exposed to the development of malnutrition and even cachexia. For this reason, intensive counseling and individual diet modification should be used in all patients undergoing radio and chemotherapy

Malnutrition of the oncological patient - diagnosis and prevention

Introduction: Malnutrition is an important medical problem which affects more than half of patients at the time of diagnosis of cancer, before any treatment begins. Deficits of nutrients in this group of patients have enormous impact on the course of the disease, tolerance of anti-cancer treatment, quality of life and mortality. Weight loss is observed in 30% to over 80% of patients and depends on the type of cancer, location and its severity. Abnormal nutritional status is also one of the causes of a weaker response to the applied anti-cancer treatment (both local and systemic) and, consequently, probably worse prognosis and shorter survival time, and more frequent occurrence of adverse effects and severe complications of anti-cancer therapy that force premature its completion. Patients with malnutrition occurs increased incidence of infectious complications, which worsens their prognosis. Worse healing of wounds after surgical procedures is observed, patient stays longer in the hospital, and the date of commencement of adjuvant treatment goes away. Cancer cachexia may result in feelings of weakness, fatigue, and increase the risk of depression and aggravate the general condition. The aim of the work is to present the essence of the problem which is malnutrition, especially in oncological patients. Summary: Proper nutrition, adapted to the current clinical situation and covering demand, is still an underestimated element of treatment of patients. Properly conducted nutritional therapy in oncological patients is an important element of treatment, because it creates optimal conditions for recovery and reduces the risk of relapse

Clinical factors affecting survival in patients with D-transposition of the great arteries after atrial switch repair: A meta-analysis

BACKGROUND: Atrial switch repair (AtrSR) was the initial method of operation in patients with D-transposition of the great arteries (D-TGA) constituting the right ventricle as a systemic one. Currently, it has been replaced with arterial switch operation (ASO), but the cohort of adults after AtrSR is still large and requires strict cardiological management of late complications. For this reason, we aimed to evaluate potential long-term mortality risk factors in patients with D-TGA after AtrSR (either Mustard or Senning procedure) METHOD: We searched MEDLINE database for suitable trials. We included 22 retrospective and prospective cohort studies of patients with D-TGA with at least 5 years mean/median follow-up time after Mustard or Senning procedure, with an end-point of non-sudden cardiac death (n-SCD) and sudden cardiac death (SCD) after at least 30 days after surgery. RESULTS: A total of 2912 patients were enrolled, of which 351 met the combined endpoint of n-SCD/SCD. The long-term mortality risk factors were: New York Heart Association class ≥ III /heart failure hospitalization (OR = 7.25; 95% CI, 2.67–19.7), tricuspid valve regurgitation (OR = 4.64; 95% CI, 1.95–11.05), Mustard procedure (OR = 2.15; 95% CI, 1.37–3.35), complex D-TGA (OR = 2.41; 95% CI, 1.31–4.43); and right ventricle dysfunction (OR = 1.94; 95% CI, 0.99–3.79) tends to be a risk factor. Supraventricular arrhythmia (SVT; OR = 2.07; 95% CI, 0.88–4.85) and pacemaker implantation (OR = 2.37; 95% CI, 0.48–11.69) did not affect long-term survival in this group of patients. In an additional analysis, SVT showed a statistically significant impact on SCD (OR = 2.74; 95% CI, 1.36–5.53) but not on n-SCD (OR = 1.5; 95% CI, 0.37–6.0). CONCLUSIONS: This meta-analysis identified that at least moderate tricuspid valve regurgitation, NYHA class ≥ III / heart failure hospitalization, right ventricle dysfunction, complex D-TGA and Mustard procedure as risk factors of long-term mortality in patients after AtrSR