Pancreatite aguda induzida por vincristina em cão com linfoma multicêntrico

Background: The vitality domain of intrinsic capacity (IC) represents the synthesis of biological interactions and metabolism. As part of the Integrated Care for Older People (ICOPE) program developed by the World Health Organization (WHO), vitality focuses on the nutritional status of older adults. The objective of this work was to describe the vitality domain of IC in community-dwelling older people and to examine the associations of the vitality components (appetite loss and weight loss) with the other IC domains assessed within the framework of ICOPE. Methods: Cross-sectional data were obtained between January 2020 and February 2022 through the INSPIRE-ICOPE-Care program, a real-life ICOPE implementation initiative developed in the Occitania region of France. Participants were men and women aged 60 and older, looking for primary care services within the French healthcare system. Results: Appetite loss was reported by 14.0% (2013) of the participants, and weight loss by 12.4% (1788). A total of 863 participants (6.01%) declaring weight loss also suffered from appetite loss. In total, 2910 participants (20.27%) screened positive for the domain of vitality. Appetite loss was significantly associated with positive screenings for the domains of cognition (OR = 2.14 [1.84;2.48]), vision (OR = 1.51 [1.28;1.79]), hearing (OR = 1.18 [1.01;1.37]), psychology (OR = 3.95 [3.46;4.52]), and locomotion ‘OR = 2.19 [1.91;2.51]). We found significant associations of weight loss with the IC domains of cognition (OR = 1.65 [1.42;1.93]), psychology (OR = 1.80 [1.56;2.07]), locomotion (OR = 1.64 [1.41;1.91]), vision (OR = 1.24 [1.04;1.47]), and hearing (OR = 1.32 [1.12;1.55]). People reporting simultaneous appetite and weight loss showed higher odds of screening positive for psychological (OR = 5.33 [4.53;6.27]) and locomotion impairments (OR = 3.38 [2.88;3.98]). Conclusions: Appetite and weight loss are common among older people and are related to other potential IC impairments, especially psychological and locomotion. Further studies are needed to explore the longitudinal associations of vitality with the incidence of clinically meaningful declines in the other IC domains.

Poster 10: A Randomized, Controlled Trial of Atomoxetine for Cognitive Dysfunction in Early Huntington's Disease

This study aimed to assess the most common physical side effects experienced by local chemotherapy patients. Their perceptions of these side effects and informational needs from clinical pharmacists were also evaluated. This was a single-center, cross-sectional study. A face-to-face interview guided by a structured questionnaire with cancer patients admitted to receive repeated cycles of chemotherapy was conducted. Information collected included chemotherapy-related side effects after last chemotherapy experience, the most worrisome side effects, the side effects overlooked by healthcare professionals and the preferred method, amount and source of receiving related information. Of 99 patients recruited, 90 participated in this survey (response rate: 90.9%). The majority were in the age range of 45-64 years (73.3%) and female (93.3%). Seventy-five (83.3%) and seventy-one (78.9%) experienced nausea and vomiting, respectively. Both symptoms were selected as two of the most worrisome side effects (16.7% vs. 33.3%). Other common and worrisome side effects were hair loss and loss of appetite. Symptoms caused by peripheral neuropathies were perceived as the major symptoms being overlooked (6.7%). Most patients demanded information about side effects (60.0%) and they would like to receive as much information as possible (86.7%). Oral conversation (83.3%) remained as the preferred method and the clinical pharmacist was preferred by 46.7% of patients as the educator in this aspect. The high prevalence of chemotherapy-related side effects among local patients is of concern. Findings of their perceptions and informational needs may serve as a valuable guide for clinical pharmacists to help in side effect management in Malaysia.

Weight and appetite regulation have been associated with the expression and secretion of ATPase inhibitory factor 1 (IF1) and growth differentiation factor-15 (GDF-15), 2 potential biomarkers for age-related mitochondrial dysfunction. The aim was to explore the associations between these biomarkers and nutritional variables in the Multidomain Alzheimer Preventive Trial study. IF1 and GDF-15 plasma levels were quantified at 1-year follow-up. The nutritional status was measured using the Mini Nutritional Assessment (MNA) score variation between baseline and 1- and 2-year visits; appetite loss was extracted from the MNA. Bodyweight was measured every 6 months until the third year and then yearly until the fifth year of follow-up, and weight loss was established if the loss was greater than 5% or 10% within the past 6 or 12 months, respectively. Bidirectional associations of IF1 and GDF-15 levels with malnutrition, appetite, and weight loss were examined. The interactions between individual IF1 and GDF-15 with sex were explored. Four hundred and forty-eight participants had MNA data and 1 045 had weight loss data. All the associations between IF1 levels and the MNA score, appetite loss, and weight loss were nonsignificant. Higher GDF-15 levels were cross-sectionally associated with appetite loss at the first year of follow-up, and the GDF-15 highest quartile was associated with nearly 80% higher risks of weight loss over 4 years. Interactions between IF1 and GDF-15 levels, and between these 2 markers and sex were not significantly associated with the outcomes. GDF-15 plasma levels were related to key malnutrition criteria.

Background Appetite loss is a common and distressing symptom in non-small-cell lung cancer (NSCLC), driven by both treatment side effects and disease progression. It often leads to unintended weight loss and cancer cachexia, significantly impairing patients’ quality of life and survival. Yet, appetite loss remains under-recognized in oncology care, with no standard assessment tools or universal management guidelines. In this study, we developed a predictive model to identify clinically meaningful thresholds of appetite loss that were associated with significant weight reduction and decreased survival. We aim to highlight the clinical consequences of appetite loss and advocate for more patient-centered treatment strategies that address this often overlooked but impactful symptom in cancer care. Methods We analyzed longitudinal patient-reported appetite scores, measured by the Lung Cancer Symptom Scale (LCSS), and body weight data from 476 NSCLC patients receiving supportive care and recovering from prior chemoradiotherapy (recovering cohort). A mechanism-based population modeling approach was used to predict the impact of appetite changes on body weight, accounting for significant data variability and missingness. Model validation was conducted using data from 380 NSCLC patients undergoing docetaxel chemotherapy (chemotherapy cohort). Clinically meaningful appetite loss thresholds were determined based on the model-predicted appetite loss associated with a 3.5 kg body weight loss and significantly worse survival (p < 0.05). Results We found that, according to the LCSS (100 mm visual analogue scale), a 30 mm improvement in appetite corresponded to a 3.5 Kg weight gain in the recovering cohort, while a 23 mm decline correlated with a 3.5 Kg weight loss in the chemotherapy cohort. Significant associations were observed between appetite loss trajectories and overall survival. Clinically meaningful thresholds for appetite loss were identified as 4 mm at 1 month and 11 mm at 3 months, both significantly associated with reduced OS in patients receiving docetaxel chemotherapy. Conclusions We developed a population predictive model to characterize the relationship between patient-reported appetite and body weight, identifying clinically meaningful thresholds for appetite loss. This work highlights the importance of managing appetite loss in oncology care and supports its use as a quantitative endpoint in clinical trials and practice.

Background: Aspiration of coelomic fluids from coelomic cavities is a simple and relatively, non-invasive technique to achieve a diagnosis. Pleural effusion, pericardial effusion and peritoneal effusion are commonly encountered problem by general physicians and chest physician. Effusion often present as a common diagnostic dilemma as no cause can be found in many cases inspite of careful evaluation. A better knowledge of spectrum of clinical history and clinical signs of pleural effusion, pericardial effusion and peritoneal effusion along with radiological, biochemical and cytological evaluation of the fluids helps in narrowing the diagnostic dilemma faced by physicians and helps in better management of patients. Objective: This study was undertaken to evaluate the coelomic fluids and its clinical correlation with cytologic diagnosis. Method: This was a prospective study conducted on 70 patients of pleural, pericardial and peritoneal effusions, satisfying inclusion criteria during the period between January 2012 to May 2013, presenting to the department of pathology, College of medical Sciences-Teaching hospital, Bharatpur. A detailed clinical history of the patient was obtained from the clinical protocol of hospital records in the proforma. Fluid from the pleural, pericardial and peritoneal cavity was obtained by thoracocentesis, pericardiocentesis and paracentesis performed by clinicians and analyzed for cytological diagnosis. Then, the cytological findings and clinical diagnosis were correlated. Statistical analysis was done using SPSS (Statistical Package for Social Sciences). The body fluids submitted from different department of COMS-TH were evaluated by cytological study and its clinical correlation was done. The prime objective of this study was to convey a diagnosis which would guide a clinician to correct diagnosis, hence the therapy. Results: The present study includes 70 cases of pleural fluid, pericardial fluid and peritoneal fluid and analysis was done. Out of 70 cases, 34 cases are of peritoneal fluid, 31 cases are of pleural fluid and five cases are of pericardial fluid. Age of the patients ranged from eight years to ninety years with males to female ratio of 1.6:1 with a mean age of 50.36 years. The most common presenting complain were abdominal distension, swelling of lower limbs and yellowish discoloration of sclera (42.9%) followed by cough, fever, chest pain, shortness of breath, loss of appetite and loss of weight (30%) followed by abdominal distension, swelling of lower limbs, yellowish discoloration of sclera, loss of appetite and loss of weight (12.9%) followed by chest pain, shortness of breath, loss of appetite and loss of weight (7.1%) followed by cough, fever, and chest pain (5.7%) followed by loss of appetite and loss of weight (1.4%). Out of 70 cases, 59 cases diagnosed as chronic effusion (84.28%). Six cases are diagnosed as inflammatory effusion (8.57%) and five cases are of malignant effusion (7.14%) on cytological evaluation. Out of five cases of malignant effusion two cases are of malignant mesothelioma. Of the total 70 cases of effusion, 50% were turbid, 47% were clear and 2.9% were hemorrhagic in appearance. 52.9% of effusions were exudative and 47.1% of effusion were transuadative. The mean fluid glucose level on transudative effusion were in the range of 80.15 ± 21.19 mg/dl which was higher as compared to exudative effusion and this difference was statistically highly significant (p value = 0.010). The mean fluid total protein levels in transudative effusion were in the range of 2.08 ± 0.43 gm/dl which can be classified as transudative form as compared to exudative form and this is highly statistically significant (p value = 0.001). The total leukocyte count ranged from 57 to 1,50,000 cells/mm3. The estimated mean ± SD of pleural, peritoneal, pericardial fluid cell count of all 70 cases were 3151.5 ± 17974.06. This was statically not significant (p value = 0.141). The average cell count in malignant effusion, chronic effusion and inflammatory effusion was 620 cells/mm3, 520 cells/mm3 and 31,141 cells/mm3 respectively.

Attention deficit hyperactivity disorder (ADHD) is a common co-morbidity that affects up to 44% of children with Down syndrome (DS). There is a need for reliable, good quality research on the use of methylphenidate within this population. The objective of this study is to report our experience regarding the management of ADHD in these children using methylphenidate. This study is a retrospective observation of 21 children with DS, followed at Jérôme Lejeune Institute between 2000 and 2018. The diagnosis of ADHD was made using the Diagnostic and Statistical Manual of Mental Disorders criteria. Efficacy was measured as response or non-response on two main symptoms: attention/concentration and hyperactivity/impulsivity. Safety was evaluated by the presence or absence of side effects. Sixteen out of the 21 children (76%) showed improvement with methylphenidate. The average age of treatment onset in responding children was 8years and 10months versus 6years and 3months in non-responders (P=0.05). Average dose/weight was significantly different in responders and non-responders (0.82 vs. 0.54mg/kg/day, respectively; P=0.03). Twelve children out of 21 (57%) experienced side effects; only three experienced side effects severe enough to require treatment interruption. Most common side effects were loss of appetite and difficulties in falling asleep. Methylphenidate was effective and safe in treating ADHD in 76% of cases in children with DS, with few serious side effects to report. Early diagnosis of ADHD is important to improve the quality of life, learning, inclusion and socialisation of children with DS.

Evaluating Benefit-risk Decision-making in Spinal Muscular Atrophy: A First-ever Study to Assess Risk Tolerance in the SMA Patient Community

Antidepressant-Resistant Depression in Patients With Comorbid Subclinical Hypothyroidism or High-Normal TSH Levels.

160 Study of interaction with a group of cancer patients: guiding cancer patients through psychoeducational interventions

Gastric neuroendocrine carcinomas (GNECs) are rare tumors characterized by an aggressive clinical course, rapid progression, metastatic dissemination, and poor prognosis. Due to overlapping radiological features and small pre-operative biopsy specimens, they are frequently misdiagnosed as adenocarcinoma in the pre-operative period. These tumors are generally asymptomatic or present with non-specific symptoms like epigastric pain or discomfort, weight loss, and loss of appetite. However, GNECs presenting as perforation peritonitis are rarely reported in the literature. A 60-year-old man presented to the emergency department with complaints of pain upper abdomen with loss of weight and appetite for four months. He had an endoscopic biopsy report suggestive of antral growth reported as poorly differentiated adenocarcinoma. Radiological investigations were notable for the presence of a malignant lesion in the stomach with perforation. Subtotal gastrectomy with D1 lymph node resection was done. Specimen pathology confirmed poorly differentiated high grade large cell neuroendocrine carcinoma. This article emphasizes the importance of considering GNEC as a differential diagnosis for gastric adenocarcinoma despite overlapping radiological features and challenges with pre-operative diagnosis due to its aggressive nature and to allow for appropriate management.

The prevalence of weight loss in esophageal carcinoma patients is high and associated with impairment of physical function, increased psychological distress and low quality of life. It is not known which factors may contribute to weight loss in patients with esophageal carcinoma during radiotherapy in China. The objective of this study was to identify the associated demographic and clinical factors influencing weight loss. We evaluated 159 esophageal carcinoma patients between August 2010 and August 2013 in a cross- sectional, descriptive study. Patient characteristics, tumor and treatment details, psychological status, adverse effects, and dietary intake were evaluated at baseline and during radiotherapy. A multivariate logistic regression analyss was performed to identify the potential factors leading to weight loss. 64 (40.3%) patients had weight loss ≥ 5% during radiotherapy. According to logistic regression analysis, depression, esophagitis, and loss of appetite were adverse factors linked to weight loss. Dietary counseling, early stage disease and total energy intake ≥ 1,441.3 (kcal/d) were protective factors. It was found that dietary counseling, TNM stage, total energy intake, depression, esophagitis, and loss of appetite were the most important factors for weight loss. The results underline the importance of maintaining energy intake and providing dietary advice in EC patients during RT. At the same time, by identifying associated factors, medical staff can provide appropriate medical care to reduce weight loss. Further studies should determine the effect of these factors on weight loss and propose a predictive model.

The Relationship Between Cytokine Levels and Symptoms in Patients (Pts) With Myelofibrosis (MF) From COMFORT-II, a Phase 3 Study of Ruxolitinib (RUX) Vs Best Available Therapy (BAT)

The incidence and impact of low body mass index on patients with operable lung cancer

Perceived effectiveness and side effects of intermaxillary fixation for diet control