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Diet and nutrition in palliative care

Author: Victor R Preedy
Publisher: Boca Raton, FL : CRC Press, ©2011.
Edition/Format:   Print book : EnglishView all editions and formats
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Document Type: Book
All Authors / Contributors: Victor R Preedy
ISBN: 9781439819326 1439819327 9781439819333 1439819335
OCLC Number: 651914514
Description: xvii, 446 pages : illustrations ; 26 cm
Contents: 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 --
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 --
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 --
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 --
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 --
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 --
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 --
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 --
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 --
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 --
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. 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 --
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 --
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 --
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 --
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 --
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 --
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 --
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 --
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 --
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 --
Summary Points --
Acknowledgments --
List of Abbreviations --
References. 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 --
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 --
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 --
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 --
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 --
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 --
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 --
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.
Responsibility: edited by Victor R. Preedy.

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<http://www.worldcat.org/oclc/651914514> # Diet and nutrition in palliative care
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   library:oclcnum "651914514" ;
   library:placeOfPublication <http://id.loc.gov/vocabulary/countries/flu> ;
   library:placeOfPublication <http://experiment.worldcat.org/entity/work/data/552441798#Place/boca_raton_fl> ; # Boca Raton, FL
   schema:about <http://experiment.worldcat.org/entity/work/data/552441798#Topic/palliativ_vard> ; # Palliativ vård
   schema:about <http://id.worldcat.org/fast/1147835> ; # Terminal care
   schema:about <http://id.worldcat.org/fast/1051719> ; # Palliative treatment
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   schema:about <http://experiment.worldcat.org/entity/work/data/552441798#Topic/diat> ; # Diät
   schema:about <http://experiment.worldcat.org/entity/work/data/552441798#Topic/palliative_care> ; # Palliative Care
   schema:about <http://experiment.worldcat.org/entity/work/data/552441798#Topic/nutrition_therapy> ; # Nutrition Therapy
   schema:about <http://experiment.worldcat.org/entity/work/data/552441798#Topic/palliativtherapie> ; # Palliativtherapie
   schema:about <http://id.worldcat.org/fast/893321> ; # Diet therapy
   schema:about <http://id.worldcat.org/fast/1041731> ; # Nursing
   schema:about <http://experiment.worldcat.org/entity/work/data/552441798#Topic/terminal_care> ; # Terminal Care
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   schema:contributor <http://experiment.worldcat.org/entity/work/data/552441798#Person/preedy_victor_r> ; # Victor R. Preedy
   schema:copyrightYear "2011" ;
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   schema:description "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 -- 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 -- 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 -- 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 -- 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 -- 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."@en ;
   schema:description "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 -- 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 -- 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 -- 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 -- 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 -- 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."@en ;
   schema:description "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 -- 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 -- 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 -- 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 -- 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 -- 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 -- 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 -- 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."@en ;
   schema:description "8.5.2.2. Pharmacological Interventions -- 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 -- 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 -- 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 -- 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 -- 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."@en ;
   schema:description "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 -- 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 -- 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 -- 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 -- 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 -- Summary Points -- Acknowledgments -- List of Abbreviations -- References."@en ;
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