Impact of nutrition on outcome: A prospective randomized controlled trial in patients with head and neck cancer undergoing radiotherapy
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Background. We aimed to determine the effect of dietary counseling or oral supplements on outcome for patients with cancer, specifically, nutritional outcome, morbidity, and quality of life (QOL), during and 3 months after radiotherapy. Methods. Seventy-five patients with head and neck cancer who were referred for radiotherapy (RT) were randomized to the following groups: group 1 (n = 25), patients who received dietary counseling with regular foods; group 2 (n = 25), patients who maintained usual diet plus supplements; and group 3 (n = 25), patients who maintained intake ad lib. Nutritional intake (determined by diet history) and status (determined by Ottery's Subjective Global Assessment), and QOL (determined by the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire version 3.0 [EORTC QLQ-C30]) were evaluated at baseline, at the end of RT, and at 3 months. Results. Energy intake after RT increased in both groups 1 and 2 (p ≤ .05). Protein intake also increased in both groups 1 and 2 (p ≤ .006). Both energy and protein intake decreased significantly in group 3 (p < .01). At 3 months, group 1 maintained intakes, whereas groups 2 and 3 returned to or below baseline levels. After RT, >90% of patients experienced RT toxicity; this was not significantly different between groups, with a trend for reduced symptomatology in group 1 versus group 2/group 3 (p < .07). At 3 months, the reduction of incidence/severity of grade 1+2 anorexia, nausea/vomiting, xerostomia, and dysgeusia was different: 90% of the patients improved in group 1 versus 67% in group 2 versus 51% in group 3 (p < .0001). After RT, QOL function scores improved (p < .003) proportionally with improved nutritional intake and status in group 1/group 2 (p < .05) and worsened in group 3 (p < .05); at 3 months, patients in group 1 maintained or improved overall QOL, whereas patients in groups 2 and 3 maintained or worsened overall QOL. Conclusions. During RT, nutritional interventions positively influenced outcomes, and counseling was of similar/higher benefit; in the medium term, only counseling exerted a significant impact on patient outcomes. © 2005 Wiley Periodicals, Inc. Head Neck 27: XXX–XXX, 2005Keywords:
Anorexia
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Cancer Chemotherapy
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Nausea and vomiting are among the most distressing adverse effects of cancer chemotherapy. In the past ten years considerable advances in the prevention of chemotherapy-induced emesis have been made. However, nurses still play a vital role in managing this condition, particularly that of anticipatory nausea and vomiting which is refractory to anti-emetic drugs and is more prevalent in children and adolescents. This article describes the management of chemotherapy-induced nausea and vomiting in an adolescent girl.
Cancer Chemotherapy
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Background: The present study aimed to explore the consultation prevalence, differential diagnoses, and management of patients presenting with nausea or vomiting to their family doctors. Methods: Cross-sectional data were collected from randomly selected patients during the SESAM 2 study ( October 1, 1999 to September 30, 2000). We contacted 2510 doctors; 270 (10.8%) of them participated in the study. Data were collected from randomly selected patients previously known to the general practitioner. Unpublished but publicly available data from the Dutch Transition Project were also analysed. Results: One hundred and sixty-nine of the total 8874 patients consulted their general practitioner for nausea/vomiting; 97 (57.4%) were female and 72 (42.6%) were male. Most patients suffering from nausea or vomiting in general practice were aged between 15 and 64 years. Nearly all patients were given a physical examination. Most diagnoses were made without further investigation, additional diagnostic procedures were found to be necessary in only 7 patients. Drugs were prescribed as the most frequent form of medical treatment, in 76.3% of cases. Non-infectious gastroenteritis or colitis was the most frequent diagnosis. Nausea or vomiting was associated with diarrhoea, fever, and abdominal pain. Headache, general weakness, and epigastric pain were also statistically significantly associated with nausea or vomiting. Conclusions: Many disorders cause nausea or vomiting. Although most of the patients were diagnosed with non-infectious gastroenteritis or colitis, the general practitioner also has to bear in mind that nausea and vomiting may be alarm symptoms. Medication was prescribed in most of the cases and there were only a few referrals to a specialist or hospital. Life-threatening disorders (appendicitis, bowel obstruction/ileus) were found in a few cases presenting with nausea or vomiting. doi:10.4021/jocmr410w
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Background: The present study aimed to explore the consultation prevalence, differential diagnoses, and management of patients presenting with nausea or vomiting to their family doctors. Methods: Cross-sectional data were collected from randomly selected patients during the SESAM 2 study ( October 1, 1999 to September 30, 2000). We contacted 2510 doctors; 270 (10.8%) of them participated in the study. Data were collected from randomly selected patients previously known to the general practitioner. Unpublished but publicly available data from the Dutch Transition Project were also analysed. Results: One hundred and sixty-nine of the total 8874 patients consulted their general practitioner for nausea/vomiting; 97 (57.4%) were female and 72 (42.6%) were male. Most patients suffering from nausea or vomiting in general practice were aged between 15 and 64 years. Nearly all patients were given a physical examination. Most diagnoses were made without further investigation, additional diagnostic procedures were found to be necessary in only 7 patients. Drugs were prescribed as the most frequent form of medical treatment, in 76.3% of cases. Non-infectious gastroenteritis or colitis was the most frequent diagnosis. Nausea or vomiting was associated with diarrhoea, fever, and abdominal pain. Headache, general weakness, and epigastric pain were also statistically significantly associated with nausea or vomiting. Conclusions: Many disorders cause nausea or vomiting. Although most of the patients were diagnosed with non-infectious gastroenteritis or colitis, the general practitioner also has to bear in mind that nausea and vomiting may be alarm symptoms. Medication was prescribed in most of the cases and there were only a few referrals to a specialist or hospital. Life-threatening disorders (appendicitis, bowel obstruction/ileus) were found in a few cases presenting with nausea or vomiting. doi:10.4021/jocmr410w
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Objectives The purpose of this case study was to evaluate the effects of Sasang Constitutional diagnosis and treatment of recurrent gastric cancer patient. Methods Nausea and vomiting of recurrent gastric cancer patient was diagnosed Soyangin Emheooyol Pattern based on their Nature & Emotion, physical characteristics, symptoms. He was medicated dokhwaljihwang-tanggami. Results and Conclusions Nausea and vomiting of recurrent gastric cancer patient who was treated with Dokhwaljihwang-tanggami showed improvement in nausea vomiting appetite loss and general condition. This case study describe the effectiveness on Nausea and vomiting of Recurrent Gastric Cancer Patient by using Dokhwaljihwang-tanggami.
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Thyrotoxicosis has a variety of presentations which depend on its severity and duration, as well as the age of the patient. Nausea and vomiting as major presenting symptoms of thyrotoxicosis are rarely reported. We report three patients with nausea and vomiting as major presenting symptoms of thyrotoxicosis, where two of the patients were extensively investigated, and thyrotoxicosis was not suspected until late in the disease. In reporting these patients we aim at drawing attention to these forgotten symptoms of thyrotoxicosis, and particularly to emphasize that, at times nausea and vomiting may be the only presenting features of thyrotoxicosis, leading to considerable difficulty in diagnosis. Moreover, these case reports give further support to the contention that thyroid studies should be carried out in border indications than conventionally accepted. J Endocrinol Metab. 2018;8(4):79-81 doi: https://doi.org/10.14740/jem511w
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Objectives To assess the nursing method of nausea and vomiting in chemotherapy of gastric cancer, which relieved suffers and helped the patients to finish the chemotherapy smoothly.Methods In the experiment group, effective psychological intervention, accompany with antivomit drug were given to prevent nausea and vomiting, diet management and nutrition support were also enhanced. In the control group, only antivomit drug and routine nursing method were given. Nausea and vomiting of patients in chemotherapy were observed and recorded respectively.Results There were statistical differences between the nursing effects of two groups of patients. Conclusions Nausea and vomiting were the most common adverse effect of chemotherapy. Effective nursing accompany with combined medication could effectively prevent and control the occurrence of nausea and vomiting in chemotherapy, which relieved the suffers of patients.
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Summary We collected data on postoperative nausea and vomiting from 3850 patients aged 11–91 years. Thirty‐seven percent of the 3244 patients who received a general anaesthetic reported nausea and 23.2% vomited. Twenty percent of the 606 patients who received a local anaesthetic reported nausea and 11.4% vomited. Of the general anaesthetic patients reporting nausea, 72.2% were women, and the mean age was lower than for those who did not (p < 0.001). Similarly for vomiting, 74.0% were women and again the mean age was lower (p < 0.001). Of the local anaesthetic patients reporting nausea, 62.0% were women and the mean age was lower than for those who did not (p < 0.001). Similarly for vomiting, 68.1% were women and again the mean age was lower (p < 0.001). Anxiety before general, but not local, anaesthesia was associated with postoperative nausea (p < 0.001) but not vomiting. Patients from the gynaecological, orthopaedic, ENT and general surgical wards had higher incidences of postoperative nausea and vomiting. Linear visual analogue pain scores were higher in patients with postoperative nausea and vomiting in both general and local anaesthesia groups (p < 0.001).
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