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|a 978-1-4398-1932-6
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|x Patologie. Klinická medicína
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|a 616-093.75
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|a Diet and nutrition in palliative care /
|c edited by Victor R. Preedy
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|a Boca Raton, FL :
|b CRC Press,
|c c2011
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|a xvii, 446 p. ;
|b ill. ;
|c 26 cm.
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|a Includes bibliographical references and index
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|a Machine generated contents note: Section I Setting the Scene -- ch. 1 Need for a Specialized Interest in Food and Nutrition in Palliative Care / Eleni Tsiompanou -- 1.1.Introduction -- 1.2.Nutrition is a Science and an Art -- 1.3.Nutrition as an Important Subject for Patients and their Carers -- 1.4.Recent Advances in the Science of Nutrition: Genes and the Environment -- 1.4.1.Nutrigenomics and Epigenetics: How Diet Affects Our `Internal Environment' -- 1.4.2.Telomeres -- 1.4.3.The Importance of Micronutrients on Symptom Control -- 1.4.4.Cancer Survivors -- 1.5.Multistep Approach to Nutritional Care -- 1.6.The Diet of People in Illness Should be Different to their Diet in Health -- 1.6.1.Alteration of Diet in Palliative Care Patients -- 1.6.2.Food as Medicine -- 1.6.3.Nutrition as a Safety Issue -- 1.6.4.Nutritional Care at the End-of-Life -- 1.7.Development of Specialists: The Need for Nutrition Education -- 1.8.Conclusion -- Summary Points -- Acknowledgments
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|a List of Abbreviations -- References -- ch. 2 What Do We Mean by Palliative Care? / Catherine Walshe -- 2.1.Introduction: Why is it Important to Define Palliative Care? -- 2.1.1.Changing Terms and Their Usage -- 2.1.2.Value-Laden Interpretations -- 2.1.3.Defining Palliative Care is Difficult -- 2.2.Current Definitions of Palliative Care and its Associated Terms -- 2.3.Key Elements of Definitions -- 2.3.1.Patient Population -- 2.3.2.Timing -- 2.3.3.Holistic Care (Total, Active, and Individualised Patient Care) -- 2.3.4.Patient, Family and Carers (Support for the Family), and Bereavement Care -- 2.3.5.Multidisciplinary/Multiprofessional Team -- Summary Points -- List of Abbreviations -- References -- ch. 3 The World's Major Religions' Views on End-of-Life Issues / Hans-Henrik Billow -- 3.1.Introduction -- 3.2.Demographic Challenges -- 3.3.The Various Religions -- 3.3.1.Christianity -- 3.3.1.1.Roman Catholic Perspective -- 3.3.1.2.Protestantism -- 3.3.1.3.Greek Orthodox
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|a 3.3.2.Judaism -- 3.3.3.Islam -- 3.3.4.Hindu and Sikh -- 3.3.5.Confucian and Taoism -- 3.3.6.Buddhism -- 3.4.Guidelines -- Ethical Issues -- Summary Points -- References -- ch. 4 Why Surgeons Are Ambivalent about Palliative Treatments: A Personal Perspective / Geoffrey P. Dunn -- 4.1.Introduction -- 4.2.Background: The Convergent Evolution of the Palliative Model Within and Outside of the Field of Surgery -- 4.3.What Burn Care Has Taught Surgeons about Palliative Care -- 4.4.Barriers to the Assimilation of Palliative Principles in Surgical Practice -- 4.4.1.Cognitive Barriers -- 4.4.2.Psychologic Barriers -- 4.4.3.Socioeconomic Barriers -- 4.4.4.Spiritual Barriers -- 4.5.Overcoming Surgeons' Ambivalence about Palliative Treatments: The Way Forward -- 4.6.Summary -- Key Facts -- Facts about Surgeons -- Summary Points -- List of Abbreviations -- References -- ch. 5 Sedation in Palliative Care and Its Impact on Nutrition / Constans A. Verhagen -- 5.1.Introduction
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|a 5.2.What is Palliative Sedation? -- 5.3.Appropriate Use of Palliative Sedation -- 5.4.Current Practice in Palliative Sedation -- 5.5.Guidelines for Palliative Sedation -- 5.6.Nutritional Patterns of Terminally Ill Patients -- 5.7.Feeding and Hydration in Terminally Ill Patients -- 5.7.1.Beneficial Effects of Nutrition and Hydration -- 5.7.2.Detrimental Effects of Nutrition and Hydration -- 5.7.3.Ethical Concerns Regarding Nutrition and Hydration -- 5.8.Nutrition in Sedated Patients -- 5.8.1.Important Points to Consider -- 5.8.2.Continuous Sedation -- 5.8.3.Intermittent Sedation -- 5.8.4.Light Sedation -- 5.9.Ethical Considerations of Nutrition -- 5.10.Applications to Other Areas of Terminal or Palliative Care -- 5.11.Practical Methods and Techniques -- Key Points -- Summary Point -- References -- ch. 6 Quality of Life and Aspects of Diet and Nutrition in Dying Children / Finella Craig -- 6.1.Introduction -- 6.2.Nutritional Assessment
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|a 6.3.Feeding and Nutritional Difficulties in Children with Life-Limiting/Life-Threatening Disease -- 6.3.1.Mechanical Difficulties: Unsafe Swallow, Gastro-Oesophageal Reflux (GOR) -- 6.3.2.Gut Dysfunction (Dysmotility and Hypersensitivity) -- 6.4.Physiological and Other Contributory Factors -- 6.4.1.Psychological/Social Influences -- 6.5.End-of-Life Care -- 6.6.Management -- 6.7.Tube Feeding -- 6.7.1.Types of Feeding Tubes -- 6.7.1.1.Nasogastric Tubes -- 6.7.1.2.Gastrostomy Tubes -- 6.7.1.3.Nasojejunal and Jejunostomy Tubes -- 6.7.1.4.Bolus and Continuous Tube Feeds -- 6.8.Total Parenteral Nutrition -- 6.9.Multidisciplinary Teamwork -- Ethical Issues -- Summary Points -- List of Abbreviations -- References -- ch. 7 Nutrition and Quality of Life in Adults Receiving Palliative Care / Caroline J. Hollins Martin -- 7.1.Introduction: The Importance of Nutrition during Palliative Care -- 7.2.Categories of Nutritional Support
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|a 7.3.Issues Regarding Nutritional State, and Palliative Care and Treatment -- 7.4.Quality of Life -- 7.5.Definitions of Quality of Life -- 7.6.Assessment of Quality of Life in People Receiving Palliative Care -- 7.7.Nutrition, Nutritional Interventions, and QOL -- 7.8.Application to Other Areas of Health and Disease -- Definition of Key Points -- Summary Points -- List of Abbreviations -- References -- ch. 8 Refractory Cancer Cachexia / F. Strasser -- 8.1.Introduction -- 8.2.Simple Starvation -- 8.3.Prevalence and Significance of Cancer Cachexia -- 8.3.1.Phases -- 8.3.2.Current Management of Cachexia -- 8.3.3.Refractory Cachexia -- 8.3.4.Diagnosing Cachexia -- 8.3.5.Phases of Cachexia -- 8.4.Diagnosing Refractory Cachexia -- 8.4.1.Stores -- 8.4.2.Intake -- 8.4.3.Potential -- 8.4.4.Performance -- 8.5.Treatment -- 8.5.1.Palliative Cancer Care -- 8.5.2.Treatment of Refractory Cachexia -- 8.5.2.1.Nutritional Interventions -- 8.5.2.2.Pharmacological Interventions
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|a 8.6.Psychosocial Interventions and Emotional Support -- 8.7.Applications to Other Areas of Terminal or Palliative Care -- 8.8.Practical Methods and Techniques -- 8.8.1.Interventions -- Key Points -- Ethical Issues -- Summary Points -- Acknowledgments -- List of Abbreviations -- References -- Section II Cultural Aspects -- ch. 9 Nutrition and Hydration in Palliative Care: Japanese Perspectives / Tatsuya Morita -- 9.1.Introduction -- 9.2.Concept of a Good Death for Japanese -- 9.3.Opinions of Patients, Families, and the General Public -- 9.4.Attitudes of Physicians and Nurses Toward Artificial Hydration -- 9.5.Essence of the Clinical Guideline -- 9.5.1.Aims, Target Population, and Quality of Life -- 9.5.2.Conceptual Framework -- 9.5.3.Development Process -- 9.5.4.Specific Recommendations -- 9.5.4.1.General QOL -- 9.5.4.2.Ascites -- 9.5.4.3.Thirst -- 9.5.4.4.Delirium -- 9.5.4.5.Bronchial Secretion -- 9.6.Guidelines
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|a Key Facts Regarding Artificial Hydration for Terminally 111 Cancer Patients -- Ethical Issues -- Summary Points -- Note -- References -- ch. 10 Nutritional Support in Palliative Care: Chinese Perspectives / Ching-Yu Chen -- 10.1.Introduction -- 10.2.Prevalence of Anorexia, Cachexia and Malnutrition in Terminal Cancer Patients -- 10.3.Current Status of Nutritional Support in Palliative Care -- 10.4.Applications of Complementary and Alternative Medicine in Palliative Care -- 10.5.Meaning of Nutritional Support in End-of-Life Care: Practical Guidelines -- 10.6.Ethical Dilemma Issues of Nutrition and Fluid Support in Terminal Cancer Patients -- 10.7.Conclusion -- Summary Points -- Acknowledgment -- List of Abbreviations -- References -- ch. 11 An Overview of the Indian Perspective on Palliative Care with Particular Reference to Nutrition and Diet / N. Ananthakrishnan -- 11.1.Introduction -- 11.2.Relevance of Palliative Care in India -- 11.3.Difficulty of Palliative Care in India
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|a 11.3.1.Resource Deficit -- 11.3.2.Government Policy -- 11.3.3.Attitudes of the Medical Fraternity -- 11.3.4.Lack of Open Communication -- 11.3.5.Attitudes Towards Hospices -- 11.4.Factors Conducive to a Good Palliative Care Model in the Country -- 11.4.1.Family -- 11.4.2.Support Structures -- 11.4.3.Cancer Epidemiology -- 11.4.4.Complementary and Alternate Forms of Medicine -- 11.5.Overview of Dietary and Nutritional Practices in India -- 11.6.Nutritional Issues in Palliative Care -- Ethical Issues -- Summary Points -- List of Abbreviations -- References -- ch. 12 Cultural Aspects of Forgoing Tube Feeding in American and Hong Kong Chinese Patients at the End-of-Life / Samantha Mei-Che Pang -- 12.1.Introduction -- 12.2.A Tale of Two Communities -- 12.3.To Debate or Not to Debate -- 12.4.Tube-Feeding Decision in the Cultural Context -- 12.5.Tube Feeding as an Option or a Solution -- 12.6.Eating Can Never Be Replaced -- 12.7.Different Cultures, Same Concern
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|a 12.8.Applications to Other Areas of Terminal or Palliative Care -- 12.9.Features of Tube-Feeding Decisions in Chinese Culture -- Ethical Issues -- Summary of Key Points -- Acknowledgments -- List of Abbreviations -- References -- Section III General Aspects -- ch. 13 Stents in the Gastrointestinal Tract in Palliative Care / Iruru Maetani -- 13.1.Introduction -- 13.2.Esophagus -- 13.2.1.Malignant Esophageal Stricture -- 13.2.2.Stent Placement -- 13.2.3.Practical Methods and Techniques -- 13.2.4.Efficacy and Complications -- 13.2.5.Cervical Esophagus and GE Junction -- 13.3.Stomach and Duodenum -- 13.3.1.Gastric Outlet Obstruction -- 13.3.2.Stent Placement -- 13.3.3.Practical Methods and Techniques -- 13.3.4.Efficacy and Complications -- 13.3.5.Stent Placement versus Gastrojejunostomy -- 13.4.Colorectum -- 13.4.1.Colorectal Obstruction -- 13.4.2.Stent Placement -- 13.4.3.Practical Methods and Techniques -- 13.4.4.Efficacy and Complications
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|a 13.4.5.Stent Placement versus Surgical Alternatives -- 13.5.Application of Stenting to Other Areas of Palliative Care -- Ethical Issues -- Summary Points -- List of Abbreviations -- References -- ch. 14 Artificial Nutrition, Advance Directives, and End-of-Life in Nursing Homes / Cheryl Ann Monturo -- 14.1.Introduction --
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|a Note continued: 14.2.Nursing Homes -- 14.2.1.Personnel to Meet the Demands -- 14.2.2.Palliative Care Services -- 14.2.3.Palliative Care Education -- 14.2.4.Regulations -- 14.2.5.Cognitive Impairment -- 14.3.Advance Directives -- 14.3.1.Historical Evolution -- 14.3.2.Usefulness of Advance Directives -- 14.4.Artificial Nutrition -- 14.4.1.Enteral Nutrition History -- 14.4.2.Enteral Nutrition Use -- 14.5.Practical Guidelines for Alternatives to Artificial Nutrition -- Key Features of Nursing Homes -- Ethical Issues -- Summary Points -- Acknowledgments -- List of Abbreviations -- References -- ch. 15 Support for Hydration at End-of-Life / Robin L. Fainsinger -- 15.1.Introduction -- 15.2.Background to the Hydration Controversy -- 15.3.Clarifying Terminology -- 15.4.Hydration Research -- 15.5.Social, Cultural, and Ethical Issues -- 15.6.Options for Alternative Hydration -- 15.6.1.Nasogastric Tubes and Gastrostomy -- 15.6.2.Hypodermoclysis -- 15.6.3.Rectal Hydration -- Key Points
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|a Summary Points -- References -- ch. 16 Palliative Treatment of Dysphagia / Christian Selinger -- 16.1.Introduction -- 16.2.Pathophysiology and Anatomy of Dysphagia -- 16.2.1.Neuromuscular Dysphagia -- 16.2.2.Dysphagia by Oral, Head and Neck Cancers -- 16.2.2.1.Oesophageal and High Gastric Obstruction -- 16.2.2.2.Gastric Outlet Obstruction -- 16.3.Applications to Other Areas of Terminal or Palliative Care -- 16.4.Practical Procedures and Techniques -- 16.4.1.Nasogastric Tube (NG) Insertion -- 16.4.2.Endoscopically Placed Feeding Tubes -- 16.4.3.Radiologically Induced Gastrostomy -- 16.4.4.Stents -- 16.4.5.Surgically Placed Feeding Tubes -- 16.4.6.Surgical Bypass Procedures -- 16.5.Evidence for Dysphagia Treatment According to Indication -- 16.5.1.Neurological and Muscular Disorders -- 16.5.1.1.Stroke Disease -- 16.5.1.2.Motor-Neuron Disease -- 16.5.1.3.Dementia -- 16.5.2.Other Neuromuscular Diseases -- 16.6.Head and Neck Tumours -- 16.6.1.Oesophageal and High Gastric Obstruction
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|a 16.6.2.Gastric Outlet Obstruction -- Ethical Issues -- Summary Points -- List of Abbreviations -- References -- ch. 17 Fatigue in Hospice Cancer Patients: How Do Nutritional Factors Contribute? / Shiow-Ching Shun -- 17.1.Introduction -- 17.2.Definition of Cancer-Related Fatigue (CRF) -- 17.3.Pathophysiology of Fatigue -- 17.4.Malnutrition and Cancer-Related Fatigue in Terminal Patients -- 17.4.1.Malnutrition, Cachexia, and Fatigue -- 17.4.2.Malnutrition Related to Anorexia, Treatments, and Cancer -- 17.5.Cancer-Related Symptoms Directly Influencing Food Intake and Fatigue -- 17.5.1.Head and Neck Cancer-Related Problems -- 17.5.2.Gastrointestinal System-Related Problems and Malnutrition -- 17.6.Common Physical Symptoms Related to Food Intake and Fatigue -- 17.7.Psychological Distress, Fatigue, and Malnutrition -- 17.8.Managing Cancer-Related Fatigue in Terminal Cancer Patients: Integrating Nutrition-Related Factors -- Ethical Issues -- Summary Points -- List of Abbreviation
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|a References -- ch. 18 Taste Alteration in Palliative Care / Michio Sata -- 18.1.Introduction -- 18.2.Types of Taste Alterations -- 18.2.1.Assessments of Taste Alteration -- 18.2.2.Mechanisms of Taste Alteration -- 18.3.Practical Methods and Techniques -- 18.3.1.Modification of Food -- 18.3.1.1.Flavors -- 18.3.1.2.Palatability -- 18.3.2.Agents -- 18.3.2.1.Sialogogues -- 18.3.2.2.Saliva substitutes -- 18.3.3.Nutrients -- 18.3.3.1.Zinc -- 18.3.3.2.BCAA -- 18.4.Conclusion -- Summary Points -- Acknowledgments -- List of Abbreviation -- References -- ch. 19 Olfaction in Palliative Care Patients / Yoav P. Talmi -- 19.1.Introduction -- 19.2.Biology of Olfaction -- 19.3.Causes of Impaired Olfaction -- 19.4.Practical Methods and Techniques -- Summary Points -- References -- ch. 20 Withholding or Withdrawing Nutritional Support at the End-of-Life in Six European Countries / Agnes van der Heide -- 20.1.Introduction -- 20.2.Nation-Wide Death Certificate Studies
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|a 20.2.1.Frequencies of Withholding or Withdrawing ANH in Six West European Countries -- 20.2.2.Characteristics of Patients in Whom ANH was Forgone in Six West European Countries -- 20.3.Communication About Withholding or Withdrawing ANH -- 20.4.Withholding or Withdrawing ANH in Combination with Possibly Life-Shortening Drugs to Relieve Symptoms -- 20.5.International Differences -- 20.6.Applications to Other Areas of Terminal or Palliative Care -- 20.7.Guidelines -- Key Facts in How to Distinguish Forgoing Artificial Nutrition or Hydration from Other Medical End-of-Life Decisions -- Ethical Issues -- Summary Points -- Acknowledgments -- List of Abbreviations -- References -- Section IV Cancer -- ch. 21 The Concept of Cachexia-Related Suffering (CRS) in Palliative Cancer Care / F. Strasser -- 21.1.Introduction -- 21.2.Malnutrition -- 21.3.Cachexia-Related Suffering (CRS) -- 21.3.1.Prevalence of CRS -- 21.3.2.Characteristics of CRS -- 21.3.2.1.Presentation of CRS
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|a 21.3.2.2.Mechanisms Leading to CRS -- 21.3.3.Reactions to CRS -- 21.3.3.1.Constructive Reactions -- 21.3.3.2.Adverse Reactions -- 21.3.4.Assessment of CRS -- 21.4.Applications to Other Areas of Terminal or Palliative Care -- 21.5.Practical Methods and Techniques -- Key Points -- Ethical Issues -- Summary Points -- Acknowledgments -- List of Abbreviations -- References -- ch. 22 An Overview of Gastrointestinal Side Effects in Tumour Therapy: Implications for Nutrition / Frank Mayer -- 22.1.Introduction -- 22.2.Nausea and Vomiting -- 22.2.1.Pharmacological Therapy of Nausea and Vomiting -- 22.2.2.Nutritional Impact of Nausea and Vomiting -- 22.2.2.1.General Aspects -- 22.2.2.2.Ginger to Prevent or Reduce Emesis -- 22.3.Mucositis -- 22.3.1.Prevention and Therapy of Mucositis -- 22.3.2.Nutritional Impact of Mucositis -- 22.4.Diarrhoea -- 22.4.1.Assessment and Early Intervention -- 22.4.2.Nutritional Impact of Diarrhoea -- 22.4.2.1.Glutamine for Protection of the Intestinal Mucosa
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|a 22.4.2.2.Probiotics for Prevention of Diarrhoea -- 22.5.Constipation -- 22.5.1.Pharmacological Therapy of Constipation -- 22.5.2.Managing Constipation -- 22.5.3.Nutritional Impact of Constipation -- 22.6.Changes in Perception of Taste and Smell -- Key Facts of Malnutrition -- Ethical Issues -- Summary Points -- List of Abbreviations -- References -- ch. 23 Nutritional Status and Relationship to Upper Gastrointestinal Symptoms in Patients with Advanced Cancer Receiving Palliative Care / Tiziana Sappia -- 23.1.Introduction -- 23.1.1.Malnutrition: Causes and Consequences -- 23.2.Application to Other Areas of Palliative Care -- 23.3.Practical Procedures and Techniques -- 23.3.1.Case History -- 23.3.2.Dietary Records -- 23.3.3.Physical Examination -- 23.3.4.Anthropometric Assessment -- 23.3.4.1.Body Weight -- 23.3.4.2.Body Height -- 23.3.4.3.Circumferences -- 23.3.5.Laboratory Analysis -- 23.3.5.1.Plasma Proteins -- 23.3.5.2.Laboratory Analysis to Assess Muscle Mass
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|a 23.3.5.3.Nitrogen Balance -- 23.3.5.4.Immunological Tests -- 23.3.5.5.Functional Tests -- 23.3.6.Nutritional Screening Tools -- 23.3.7.Human Body Composition -- 23.3.7.1.Body Composition Measurement Techniques -- 23.4.Aspects of Nutritional Status in Palliative Care -- 23.5.Relationship between Nutritional Status and Upper Gastrointestinal Symptoms -- Ethical Issues -- Summary Points -- List of Abbreviations -- References -- ch. 24 Nutrition and Palliative Surgery for Head and Neck Cancer / Ryuichi Hayashi -- 24.1.Introduction -- 24.1.1.Advanced Head and Neck Cancer -- 24.1.2.Nutrition and Quality of Life -- 24.2.Applications in Other Areas of Terminal or Palliative Care -- 24.3.Practical Methods and Techniques -- 24.3.1.Palliative Surgery -- 24.3.2.Complications and Hospitalization -- 24.3.3.Case 1 -- 24.3.4.Case 2 -- 24.3.5.Indication -- Key Facts of Head and Neck Cancer -- Ethical Issues -- Summary Points -- List of Abbreviations -- References
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|a ch. 25 Total Parenteral Nutrition for Patients with Advanced, Life-Limiting Cancer: Clinical Context, Potential Risks and Benefits, and a Suggested Approach / Jane L. Wheeler -- 25.1.Introduction -- 25.2.Metabolic Changes in the Patient with Advanced Cancer -- 25.3.Cancer Anorexia-Cachexia Syndrome -- 25.4.Total Parenteral Nutrition -- 25.5.Clinical Risks Associated with TPN -- 25.6.Potential Negative Effects of TPN -- 25.7.Potential Positive Effects of TPN -- 25.8.Applications to Other Areas of Terminal or Palliative Care -- 25.9.Guidelines for Clinical Practice -- 25.9.1.Guidelines for Patients with Advanced Cancer -- 25.9.2.Additional Factors Influencing the Palliative Use of TPN -- 25.9.3.TPN: A Pragmatic Clinical Approach -- Key Points to Communicate to Patients and Their Families -- Ethical Issues -- Summary Points -- List of Abbreviations -- References -- ch. 26 Vitamin Deficiency in Patients with Terminal Cancer / Dominic J. Harrington -- 26.1.Introduction
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|a 26.1.1.Challenges Faced by Patients with Terminal Cancer -- 26.2.Fat-Soluble Vitamins -- 26.2.1.Vitamin A -- 26.2.2.Vitamin D -- 26.2.3.Vitamin E -- 26.2.4.Vitamin K -- 26.3.Water-Soluble Vitamins -- 26.3.1.Vitamin C (Ascorbic Acid) -- 26.3.2.Folate (Vitamin B9) -- 26.3.3.Vitamin B12 -- 26.3.4.Vitamin B6 -- 26.3.5.Thiamine (Vitamin B1) -- 26.3.6.Riboflavin (Vitamin B2) -- 26.3.7.Niacin (Vitamin B3) -- 26.3.8.Biotin (Vitamin B7) -- 26.3.9.Pantothenic Acid (Vitamin B5) -- 26.4.Practical Methods and Techniques -- 26.4.1.Fat-Soluble Vitamins -- 26.4.1.1.Vitamin A -- 26.4.1.2.Vitamin D -- 26.4.1.3.Vitamin E -- 26.4.1.4.Vitamin K -- 26.4.2.Water-Soluble Vitamins -- 26.4.2.1.Vitamin C -- 26.4.2.2.Folate -- 26.4.2.3.Vitamin B12 -- 26.4.2.4.Vitamin B6 -- 26.4.2.5.Thiamine (Vitamin B1) -- 26.4.2.6.Riboflavin (Vitamin B2) -- 26.4.2.7.Niacin (Vitamin B3) -- 26.4.2.8.Biotin (Vitamin B7) -- 26.4.2.9.Pantothenic Acid (Vitamin B5) -- Key Facts: Vitamin Deficiency in Patients with Terminal Cancer
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|a Summary Points -- Acknowledgments -- List of Abbreviations -- References --
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|a Note continued: ch. 27 Position of Appetite and Nausea in Symptom Clusters in Palliative Radiation Therapy / Edward Chow -- 27.1.Introduction -- 27.2.Key Features of Symptom Clusters -- 27.2.1.What Are They? -- 27.2.2.Why Are They Useful? -- 27.3.Tools Used in Symptom Cluster Research -- 27.4.Radiation-Induced Nausea/Vomiting -- 27.5.Nausea/Vomiting and Appetite in Symptom Clusters in Bone Metastases -- 27.6.Nausea/Vomiting and Appetite in Symptom Clusters in Brain Metastases -- 27.6.1.Studies Conducted -- 27.6.2.Study Conclusions -- 27.7.Applications to Other Areas of Palliative Care -- 27.8.Guidelines -- Ethical Issues -- Summary Points -- List of Abbreviations -- References -- ch. 28 Palliative Gastrojejunostomy and the Impact on Nutrition in Cancer / Jeffrey M. Farma -- 28.1.Introduction -- 28.1.1.Acute Presentation of GOO -- 28.1.2.Clinical Presentation -- 28.1.3.Diagnostic Evaluation -- 28.2.Nutritional Complications of GOO -- 28.2.1.Proximal GOO
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|a 28.2.2.Duodenal and Biliary Obstruction -- 28.2.3.Pancreatic Duct Obstruction -- 28.2.4.Nutritional Deficiencies -- 28.3.Surgical Techniques -- 28.3.1.Gastrojejunostomy -- 28.3.2.Risks Associated with Gastrojejunostomy -- 28.3.3.Partial Stomach-Partitioning Gastrojejunostomy -- 28.3.4.Role of Prophylactic Gastrojejunostomy -- 28.4.Biliary Obstruction -- 28.5.Minimally Invasive Surgical Techniques -- 28.6.Non-Surgical Options -- 28.7.Guidelines -- Ethical Issues -- Summary Points -- List of Abbreviations -- References -- Section V Other Conditions -- ch. 29 Nutritional Support in the Vegetative State: Artificial Nutrition and Hydration in the Limbo between Life and Death / Giuseppe Nattino -- 29.1.Introduction -- 29.1.1.The Vegetative State -- 29.1.2.Nutrition in PVS Patients -- 29.2.Applications to Other Areas of Terminal or Palliative Care -- 29.3.Practical Methods and Techniques -- 29.3.1.Energy Expenditure -- 29.3.2.Nutritional Requirements in PVS Patients
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|a 29.3.3.Enteral Feeding Routes and Techniques -- 29.3.4.Complications and Their Prevention -- 29.3.4.1.Constipation, Impaired Gastrointestinal Motility, and Diarrhea -- 29.3.4.2.Tube Occlusion -- 29.3.4.3.Accidental Tube Removal -- 29.3.4.4.Gastric Sores Due to the Internal Portion of the Tube -- 29.3.4.5.Intestinal Occlusion by Tube Dragging -- 29.4.Ethical Issues -- 29.4.1.Artificial Nutrition and Hydration (ANH): Medical Treatment or Loving Care? -- 29.4.2.Withdrawing ANH -- 29.4.3.Ethical Principles Informing the Decision -- Summary Points -- List of Abbreviations -- References -- ch. 30 Nutrition and Appetite Regulation in Children and Adolescents with End-Stage Renal Failure / Jorg Dotsch -- 30.1.Introduction -- 30.2.Appetite Regulation -- 30.2.1.Normal Appetite Regulation -- 30.2.2.Dysregulation of Appetite in End-Stage Renal Disease -- 30.2.2.1.Leptin and Ghrelin -- 30.2.2.2.Uremia -- 30.3.Protein Energy Wasting -- 30.3.1.Inflammation -- 30.3.2.Dialysate Nutrient Losses
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|a 30.3.3.Metabolic Acidosis -- 30.3.4.Endocrine Disorders and Concomitant Diseases -- 30.4.Nutrition and Diet -- 30.4.1.General Aspects of Nutrition and Diet in End-Stage Renal Failure -- 30.4.1.1.Calories, Protein, and Body Weight -- 30.4.1.2.Sodium and Fluids -- 30.4.1.3.Phosphorus and Calcium -- 30.4.1.4.Potassium -- 30.4.1.5.Vitamins and Minerals -- 30.4.2.Infants -- 30.4.3.Children -- 30.4.4.Adolescents -- 30.4.5.Adults -- 30.5.Application to Other Areas of Terminal or Palliative Care -- 30.6.Practical Methods and Techniques -- Key Facts of Renal Failure -- Ethical Issues -- Summary Points -- List of Abbreviations -- References -- ch. 31 Nutrition in End-Stage Liver Disease / Valentina Medici -- 31.1.Introduction -- 31.2.Pathophysiology of Malnutrition in End-Stage Liver Disease -- 31.3.Specific Nutrient Deficiencies in End-Stage Liver Disease and Associated Clinical Features -- 31.3.1.Protein Calorie Malnutrition -- 31.3.2.Vitamins -- 31.3.3.Minerals
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| 505 |
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|a 31.4.Evaluation of Nutritional Status in End-Stage Liver Disease -- 31.5.Treatment -- 31.6.Applications to Other Areas of Terminal or Palliative Care -- 31.7.Practical Methods and Techniques -- Key Points of Malnutrition in End-Stage Liver Disease -- Ethical Issues -- Summary Points -- List of Abbreviation -- References -- ch. 32 Nutritional Therapy in Amyotrophic Lateral Sclerosis / Susanne Petri -- 32.1.Introduction -- 32.2.Nutrition Principles in ALS -- 32.3.Management of Dysphagia -- 32.4.Enteral Nutrition in ALS -- 32.4.1.Nasogastric Tube in ALS -- 32.4.2.Percutaneous Endoscopic Gastrostomy in ALS -- 32.4.2.1.Timing of PEG Tube Placement -- 32.4.2.2.PEG and Aspiration -- 32.4.3.Percutaneous Radiologic Gastrostomy/Radiologically Inserted Gastrostomy -- 32.5.Home Parenteral Nutrition in ALS -- Ethical Issues -- Summary Points -- List of Abbreviations -- References
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| 505 |
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|a ch. 33 Nutritional Considerations of Palliative Care in Rare Disease: The Motor Disorder Disease Achalasia / Fabio Cisaro -- 33.1.Introduction -- 33.2.Pathophysiology -- 33.3.Clinical Picture and Diagnosis -- 33.4.Treatment Options -- 33.4.1.Pharmacologic Treatments -- 33.4.2.Endoscopic Procedures -- 33.4.3.Surgical Treatment -- 33.5.Applications to Other Areas of Palliative Care -- 33.6.Guidelines and Practical Methods and Techniques -- 33.7.Nutritional Aspects of Achalasia -- Ethical Issues -- Summary Points -- List of Abbreviations -- References -- Section VI Pharmacological Aspects -- ch. 34 Steroid-Induced Side Effects Affecting Diet and Nutrition in Palliative Care: Oral Candidiasis and Other Conditions / Jana Pilkey -- 34.1.Introduction -- 34.2.Oral and Esophageal Candidiasis -- 34.3.Risk Factors -- 34.4.Practical Methods and Techniques -- 34.4.1.Diagnosis -- 34.4.2.Treatment -- 34.4.3.Ethical Issues -- 34.5.Gastritis and Gastroduodenal Ulceration -- 34.5.1.Incidence
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| 505 |
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|a 34.5.2.Risk Factors -- 34.6.Practical Methods and Techniques -- 34.6.1.Prophylaxis and Treatment -- 34.6.2.Ethical Issues -- 34.7.Impaired Glucose Metabolism -- 34.7.1.Monitoring -- 34.7.2.Practical Methods and Techniques -- 34.7.2.1.Oral Agents -- 34.7.2.2.Insulin -- 34.7.3.Ethics and Diabetic Management in the Dying -- 34.7.4.Hiccups -- 34.8.Applications to Other Areas of Palliative Care -- Summary Points -- Acknowledgments -- List of Abbreviations -- References -- ch. 35 Appetite Stimulant Use in the Palliative Care of Cystic Fibrosis / Darcie D. Streetman -- 35.1.Introduction -- 35.2.Appetite Stimulants -- 35.2.1.Megestrol Acetate (MA) -- 35.2.2.Cyproheptadine Hydrochloride (CH) -- 35.2.3.Dronobinal (Marinol) -- 35.2.4.Antipsychotic/Antidepressant Agents -- 35.2.4.1.Antipsychotic Drugs -- 35.2.4.2.Antidepressants -- 35.2.5.Recombinant Human Growth Hormone (rhGH) -- 35.2.6.Anabolic Androgenic Steroids (AAS) -- 35.3.Applications to Other Areas of Terminal or Palliative Care
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| 505 |
0 |
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|a Ethical Issues -- Summary Points -- List of Abbreviations -- References -- ch. 36 Warfarin -- Nutrition Interactions in the Hospice and Palliative Care Setting / Jeffrey L. Spiess -- 36.1.Introduction -- 36.2.The Coagulation Cascade -- 36.3.Vitamin K Antagonists -- 36.4.Warfarin in Clinical Practice -- 36.5.Warfarin Indications and Cautions -- 36.6.Vitamin K -- 36.7.Vitamin K as a Therapeutic Agent -- 36.8.Non-Vitamin K Warfarin-Nutrition Interactions -- 36.9.Application to Other Areas of Terminal or Palliative Care -- 36.10.Guidelines -- Ethical Issues -- Summary Points -- Acknowledgments -- List of Abbreviations -- References.
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