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Nutrition in Advanced Cancer Care : = A Clinical Perspective.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Nutrition in Advanced Cancer Care :/
其他題名:	A Clinical Perspective.
作者:	Goodrose-Flores, Charlotte.
面頁冊數:	1 online resource (92 pages)
附註:	Source: Dissertations Abstracts International, Volume: 84-10, Section: B.
Contained By:	Dissertations Abstracts International84-10B.
標題:	Gender differences. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=30394631click for full text (PQDT)
ISBN:	9798377693123

Nutrition in Advanced Cancer Care : = A Clinical Perspective.
Goodrose-Flores, Charlotte.

Nutrition in Advanced Cancer Care :A Clinical Perspective. - 1 online resource (92 pages)

Source: Dissertations Abstracts International, Volume: 84-10, Section: B.

Thesis (Ph.D.)--Karolinska Institutet (Sweden), 2023.

Includes bibliographical references

Adequate nutrition is an essential part in all stages of cancer care. By optimizing the nutritioncare the benefits include increased tolerance to treatment as well as decreased mortality.Understanding how aspects of nutrition care in patients diagnosed with cancer, such as appetite,protein, albumin, and C-Reactive Protein (CRP), as well as body image, are intertwined arepotentially important factors in clinical practice.All studies in the thesis were performed among patients diagnosed with advanced canceradmitted to Advanced Medical Home Care in Stockholm, Sweden.In men diagnosed with advanced cancer, who had lost weight since diagnosis, we found aninverse association between weight loss and "physical functioning", as measured by theRAND-36 domain, β = -1.34 (95%CI: -2.44,- 0.24 (study I). In women, we found that weightloss was associated with improvement in the RAND-36 domain role "limitations due tophysical health"; β = 2.02 (95%CI:0.63,3.41). Women reported a more distressed body imagethan men (p = 0.02), which remained significant when only women that had lost weight afterdiagnosis were included. Further, we found an association between weight loss in men andbody image distress, β = 0.22 (95%CI:0.07,0.37).The aim of study II was to compare how high-protein parenteral nutrition (PN) affects the livercompared to standard PN. We found no significant difference in the proportion of patients withelevated liver enzymes in the high-protein PN group; OR 0.20 (95%CI:0.02,1.86). Patients thathave received high-protein PN had a significantly higher weight at follow-up when comparedto patients administered a PN containing standard amount of protein (p < 0.05).In study III we found a significant correlation in men between low appetite, measured by theEdmonton Symptom Assessment System (ESAS), and low albumin (r = 0.27, p < 0.001). Inmen, lower appetite was also correlated with a higher CRP (r = 0.27, p < 0.001). In regressionanalysis, adjusted for confounding factors, the results remained similar. In women, there wasno correlation between appetite and albumin or CRP.In a cohort analysis (study IV) moderate and poor appetite were significantly associated with ahigher mortality rate when compared to participants reporting a good appetite; HR 1.44(95%CI:1.16,1.79) and HR 1.78 (95%CI:1.39,2.29), respectively (study IV). We also foundthat participants with low albumin levels (< 25 g/L), and participants in the highest tertile ofCRP/albumin ratio, had higher mortality rates, HR 5.35 (95%CI:3.75,7.63) and HR 2.66(95%CI:2.12,3.35), when compared to participants with high albumin levels (>36 g/L) andparticipants in the lowest tertile of CRP/albumin ratio. The associations were more pronouncedin men than in women.

Electronic reproduction.
Ann Arbor, Mich. :
ProQuest,
2023

Mode of access: World Wide Web

ISBN: 9798377693123Subjects--Topical Terms:

3548331
Gender differences.
Index Terms--Genre/Form:

542853
Electronic books.

Nutrition in Advanced Cancer Care : = A Clinical Perspective.
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100 1 $a Goodrose-Flores, Charlotte. $3 3703596
245 1 0 $a Nutrition in Advanced Cancer Care : $b A Clinical Perspective.
264 0 $c 2023
300 $a 1 online resource (92 pages)
336 $a text $b txt $2 rdacontent
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500 $a Source: Dissertations Abstracts International, Volume: 84-10, Section: B.
500 $a Advisor: Lagerros, Ylva Trolle;Bjorkhem-Bergman, Linda;Bonn, Stephanie E.
502 $a Thesis (Ph.D.)--Karolinska Institutet (Sweden), 2023.
504 $a Includes bibliographical references
520 $a Adequate nutrition is an essential part in all stages of cancer care. By optimizing the nutritioncare the benefits include increased tolerance to treatment as well as decreased mortality.Understanding how aspects of nutrition care in patients diagnosed with cancer, such as appetite,protein, albumin, and C-Reactive Protein (CRP), as well as body image, are intertwined arepotentially important factors in clinical practice.All studies in the thesis were performed among patients diagnosed with advanced canceradmitted to Advanced Medical Home Care in Stockholm, Sweden.In men diagnosed with advanced cancer, who had lost weight since diagnosis, we found aninverse association between weight loss and "physical functioning", as measured by theRAND-36 domain, β = -1.34 (95%CI: -2.44,- 0.24 (study I). In women, we found that weightloss was associated with improvement in the RAND-36 domain role "limitations due tophysical health"; β = 2.02 (95%CI:0.63,3.41). Women reported a more distressed body imagethan men (p = 0.02), which remained significant when only women that had lost weight afterdiagnosis were included. Further, we found an association between weight loss in men andbody image distress, β = 0.22 (95%CI:0.07,0.37).The aim of study II was to compare how high-protein parenteral nutrition (PN) affects the livercompared to standard PN. We found no significant difference in the proportion of patients withelevated liver enzymes in the high-protein PN group; OR 0.20 (95%CI:0.02,1.86). Patients thathave received high-protein PN had a significantly higher weight at follow-up when comparedto patients administered a PN containing standard amount of protein (p < 0.05).In study III we found a significant correlation in men between low appetite, measured by theEdmonton Symptom Assessment System (ESAS), and low albumin (r = 0.27, p < 0.001). Inmen, lower appetite was also correlated with a higher CRP (r = 0.27, p < 0.001). In regressionanalysis, adjusted for confounding factors, the results remained similar. In women, there wasno correlation between appetite and albumin or CRP.In a cohort analysis (study IV) moderate and poor appetite were significantly associated with ahigher mortality rate when compared to participants reporting a good appetite; HR 1.44(95%CI:1.16,1.79) and HR 1.78 (95%CI:1.39,2.29), respectively (study IV). We also foundthat participants with low albumin levels (< 25 g/L), and participants in the highest tertile ofCRP/albumin ratio, had higher mortality rates, HR 5.35 (95%CI:3.75,7.63) and HR 2.66(95%CI:2.12,3.35), when compared to participants with high albumin levels (>36 g/L) andparticipants in the lowest tertile of CRP/albumin ratio. The associations were more pronouncedin men than in women.
533 $a Electronic reproduction. $b Ann Arbor, Mich. : $c ProQuest, $d 2023
538 $a Mode of access: World Wide Web
650 4 $a Gender differences. $3 3548331
650 4 $a Parenteral nutrition. $3 3685741
650 4 $a Womens health. $3 3562508
650 4 $a Lipids. $3 558980
650 4 $a Body mass index. $3 3562858
650 4 $a Mortality. $3 533218
650 4 $a Gender studies. $3 2122708
650 4 $a Health sciences. $3 3168359
650 4 $a Nutrition. $3 517777
650 4 $a Public health. $3 534748
655 7 $a Electronic books. $2 lcsh $3 542853
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690 $a 0566
690 $a 0570
690 $a 0573
710 2 $a ProQuest Information and Learning Co. $3 783688
710 2 $a Karolinska Institutet (Sweden). $3 3557748
773 0 $t Dissertations Abstracts International $g 84-10B.
856 4 0 $u http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=30394631 $z click for full text (PQDT)