Major Causes Of Weight Loss Research Articles

Pancreatic Enzyme Replacement Therapy in Pancreatic Cancer.

Pancreatic cancer is an aggressive malignancy and the seventh leading cause of global cancer deaths in industrialised countries. More than 80% of patients suffer from significant weight loss at diagnosis and over time tend to develop severe cachexia. A major cause of weight loss is malnutrition. Patients may experience pancreatic exocrine insufficiency (PEI) before diagnosis, during nonsurgical treatment, and/or following surgery. PEI is difficult to diagnose because testing is cumbersome. Consequently, PEI is often detected clinically, especially in non-specialised centres, and treated empirically. In this position paper, we review the current literature on nutritional support and pancreatic enzyme replacement therapy (PERT) in patients with operable and non-operable pancreatic cancer. To increase awareness on the importance of PERT in pancreatic patients, we provide recommendations based on literature evidence, and when data were lacking, based on our own clinical experience.

Weight Loss in Older Persons: New Therapeutic Approaches

There is now a large body of evidence that weight loss in older persons not only increases mortality, but also increases the incidence of hip fracture, functional deterioration and institutionalization. Weight loss is a central component of frailty. There is evidence that it is not only muscle, but also fat loss that leads to these deleterious effects. The reasons why fat loss can be harmful in older persons are reviewed. There are four major causes of weight loss in older persons viz. anorexia, sarcopenia, cachexia and dehydration. This review concentrates on the major causes of anorexia and sarcopenia. In particular, the emergence of new medications such as selective androgen receptor molecules, antimyostatin analogues, megestrol acetate (nanocrystal formulation), and ghrelin agonists are reviewed. The potential role of anabolic steroids is also discussed.

Office Management of Weight Loss in Older Persons

Weight loss in older persons is associated with a variety of deleterious effects, including hip fracture, pressure ulcers, decreasing immune function, decreased functional status, and death. There are 4 major causes of weight loss: anorexia, sarcopenia, cachexia, and dehydration. Many of the reasons for the development of these conditions are treatable. For example, depression is the most common cause of weight loss in the elderly. Early screening for anorexia can be undertaken in the physician’s office utilizing the Simplified Nutritional Assessment Questionnaire. An algorithmic approach to the office management of weight loss is provided.

Involuntary weight loss in elderly individuals: assessment and treatment.

The loss of body weight and fat late in life is associated with premature death and increased risk of disability, even after excluding elderly subjects who have a preexisting disease. Although it is important to recognize that periods of substantially positive or negative energy balance and body weight fluctuation occur as a normal part of life, weight losses greater than 5% over 6 months should be investigated. We can divide the major causes of weight loss in the elderly into 4 categories: social, psychiatric, due to medical conditions, and age-related. The clinical evaluation should include a careful history and physical examination. If these fail to provide clues to the weight loss, simple diagnostic tests are indicated. A period of watchful waiting is preferable to blind pursuit of additional diagnostic testing that may yield few useful data, if the results of these initial tests are normal. The first step in managing patients with weight loss is to identify and treat any specific causative or contributing conditions and to provide nutritional support when indicated. Non-orexigenic drugs have found an established place in the management of protein-energy malnutrition. Early attention to nutrition and prevention of weight loss during periods of acute stress, particularly during hospitalization, may be extremely important, as efforts directed at re-feeding are often unsuccessful. Narrative review.

Resting energy expenditure, weight loss, and altered body composition in HIV infection

Failure to downregulate resting energy expenditure (REE) as an adaption to anorexia or malabsorption is often stated as the major cause of weight loss in individuals with AIDS. In a prospective study, REE was compared with weight changes in HIV-infected patients. The impact of altered body composition on REE was reassessed by critical review of the literature. Patients were 65 male HIV-infected patients, 28 with recent weight loss (WL), and 37 who were weight stable (WS); 50 65 patients had AIDS, and 29 65 had acute infections; 29 male healthy persons served as controls. Indirect calorimetry, prospective intake protocol, and bioelectrical impedance analysis were performed. Absolute REE was lower in WL patients than in controls (1459 ± 309 versus 1711 ± 151 kcal/d, p < 0.001) and in WS patients (1625 ± 402 kcal/d, p < 0.05). REE/kg body cell mass (BCM) was higher in WL and WS than in controls (both p < 0.01) due to lower BCM in both patient groups ( p < 0.001). REE (%Harris-Benedict) was not different among the three groups. Weight changes around the measurement were not correlated to REE ( r 2 = 0.0008, p = 0.82). REE was independent of diarrhea, acute infection, fever, or caloric intake. REE had a stronger correlation to body weight and to Harris-Benedict's prediction than to fat-free mass or BCM. REE explains <1% of weight changes. Many patients can downregulate REE as an adaption to anorexia and/or malabsorption. Higher REE/kg BCM does not signify hypermetabolism at the cellular level but can be explained by the maintenance of energy-consuming visceral tissue within the BCM during BCM loss.

Mechanisms of Weight Loss following Intestinal Bypass Surgery.

Dramatic weight loss has been observed following intestinal bypass surgery. Initially, malabsorption was recognized as the major cause of weight loss. Only in recent years have investigators noted that the intestinal bypass could significantly reduce caloric intake, which largely or almost fully explains the weight loss following this procedure. The reduced energy intake as well as malabsorption are probably the major causes of weight loss after intestinal bypass surgery. Increased energy output has been proposed as a factor for weight loss, and more recently, it has been suggested that certain hormonal changes may play a role in regulating satiety and metabolic processes. This article examines these proposed factors that may impact on weight loss following intestinal bypass surgery.

Weight loss and weight gain in a nursing home: A prospective study: To intervene early, a multidisciplinary team attempted to determine the major causes of weight loss and weight gain

We studied a nursing home population to delineate the frequency of weight loss and weight gain, the categories of loss and gain, and the factors or causes that contribute to losses and gains. Acute illness was determined to be the major cause of weight loss at the nursing home, followed by psychiatric/psychologic disorders and dementia. Such facts encourage replication in other nursing home populations to prompt attention to weight loss and weight gain.

Physiological mass measurements on Skylab [formula omitted] and [formula omitted

Mass measurements of crewmen and objects were made for the first time in space during Skylab. A description of the new devices designed for such measurements and of the technique of their use is detailed. Results from ground-based chamber simulation tests and from those during Skylab II and III show similar patterns of simple metabolic deficits, of a rapid loss during the first few days of flight followed by a reciprocal gain for the first few postflight days, and other transient changes. It is concluded that two major causes of weight loss are present: (1) a fluid redistribution and loss, and (2) metabolic losses. Added to these are short-term changes from transient stress. Smaller, simpler, and cheaper devices have since been designed which should allow mass measurements on virtually any object in almost any spacecraft.

Organ weights and water contents of fully grown female rats

Twenty-eight female albino rats were autopsied in pairs at intervals over a period of 110 days after cessation of normal growth. Changes in weight and water content of eighteen organs were correlated with time. Weight decreased linearly with time in kidneys, muscle, small bowel, spleen, and thymus. Weight of heart, liver, adrenal glands, and ovaries decreased nonlinearly. Decrease in water content was a major cause of weight loss in heart, muscle, and ovaries. The water content of brain, cardiac and pyloric stomach, cecum, colon, heart, spleen, muscle, and skin decreased linearly with increase in time. Decrease in the water content of lungs, ovaries, kidneys, thymus, liver, and adrenals occurred mainly in the second half of the experimental period, and in submaxillary salivary glands in the first half. Changes in water content of residual carcass and small bowel were not significant, and in liver and kidneys there was little net loss at the end of 110 days. While body weight of adult female rats is deceptively constant, the composition of the body changes continuously. Lest such changes be ascribed to drug action in chronic toxicity studies, controls must be studied at each progressive interval of time.