Cachexia and Wasting provides the best available evidence on the pathogenesis, clinical features and therapeutic approach of cachexia, and facilitates the understanding of the complex yet unequivocal clinical role of this syndrome, that truly represents a disease, or, better still, a disease within other different diseases.

This book is primary written for oncologists, physicians, geriatricians, and infectivologists.

Contents

Anatomy, Historical Perspective and Epidemiology

• Functional anatomy of the "adipose organ"
• Body silhouette and body fat distribution
• Historic views on cachexia in humans with special reference to cardiac cachexia
• Epidemiology of cachexia

Biochemistry, Physiology and 'Clinics' of Adipose Tissue

• Energy values of foods
• Diet-induced thermogenesis

Assessment of Nutritional Status

• Biochemical parameters of nutrition
• Nitrogen balance and protein requirements
• Plasma proteins and protein catabolism
• Nutritional status assessment
• Immunological parameters of nutrition
• functional parameters of nutrition

The Different Features of Wasting in Humans

• Anorexia
• Starvation
• Cachexia related to multiple causes
• Non-AIDS lipodistrophy syndrome

Pathophysiology of Wasting/Cachexia

• Body composition
• Protein metabolism in cachexia
• Lipid metabolism in cachexia
• Glucose metabolism
• Cytokines in cachexia
• Cytokines in chronic inflammation
• Biochemistry of the growth hormone-relating peptides, secretagogues and ghrelin
• Ghrelin as a new factor in the central network controlling appetite and food intake
• Leptin and des-acyl ghrelin
• Brain mechanisms in wasting and cachexia
• Body wieght regulation and hypothalamic neuropeptides

Medical Causes of Wasting/Cachexia

• Diabetes
• Endocrine disorders
• Psychiatric diseases and depression
• Cachexia in chronic kidney disease
• gastrointestinal diseases
• Chronic obstructive lung disease and treatment of COPD-related cachexia
• Cachexia in cardiovascular illness

Cachexia and Aging

• Epidemiology of malnutrition in the elderly
• Pathophysiology of body composition changes in elderly people
• The pharmacokinetics and pharmacodynamics of drugs in elderly cachectic (cancer) patients
• Pathophysiology of cachexia in the elderly
• Cytokines and disability in older adults

Cachexia and HIV Infection/AIDS

• HIV infection-related cachexia and lipodystrophy
• Treatment of AIDS anorexia-cachexia syndrome and lipodystrophy

Cancer-Related Cachexia

• Cancer cachexia and fat metabolism
• The role of cytokines in cancer cachexia
• Proinflammatory cytokines
• Proteolysis-inducing factor in cancer cachexia
• Lipid mobilizing factor in cancer cachexia
• Dietary intake, resting energy expenditure, weight lose, and survival in cancer patients
• The ubiquitin/proteasome system in cancer cachexia
• Non-GI-malignancy-related malabsorption leads to malnutrition and weight loss
• Omega-3 fatty acids, cancer anorexia, and hypothalamic gene expression
• The role of pineal hormone melatonin in cancer cachexia
• Eating-related distress of patients with advanced, incurable cancer and of their partners
• Challenges of geriatric oncology

Treatment of Cancer Cachexia

• The current management of cancer cachexia
• The role of artificial nutrition support in the cancer patient
• The role of appetite stimulants for cancer-related weight loss
• Palliative management of anorexia/cachexia and associated symptoms
• Pharmaco-nutritional supports for the treatment of cancer cachexia
• A critical assessment of the outcome measure sand goals of intervention in cancer cachexia
• Meeting the amino acid requirements for protein anabolism in cancer cachexia
• Thr role of branched-chain amino acids and serotonin antagonists in the prevention and treatment of cancer cachexia
• An update on therapeutics
• Medroxyprogesterone acetate in cancer cachexia
• Progestagens and corticosteroids in the management of cancer cachexia
• COX-2 inhibitors in cancer cachexia
• Anti-TNF-α antibody and cancer cachexia
• A phase II study with antioxidants

Treatment of Cachexia in the Elderly

• Treatment of weight loss and cachexia in the elderly
• Treatment of sarcopenia and cachexia in the elderly
• Mangement of weight loss in older persons

Global Perspective for the Treatment of Cachexia

• Cachexia: therapeutic immunomodulation beyond cytokine antagonism

Index

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