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CABG ▶ Coronary Artery Bypass Graft (CABG)
lean body tissue replaced by fat mass with little or no resulting weight loss. Cachexia occurs in patients with chronic illnesses such as cancer, HIV/AIDS, chronic kidney disease, chronic heart failure, and chronic obstructive pulmonary disease.
Cachectin Description ▶ Tumor Necrosis Factor-Alpha (TNF-Alpha)
Cardiac
Etiology The etiology of cachexia is multifactorial. Increased inflammatory processes in the form of cytokine production lead to metabolic dysregulation, such as increased resting energy expenditure, and may contribute to heightened protein degradation accompanied by decreased protein synthesis. Many patients with cachexia will also experience anorexia (i.e., a loss of appetite) and decreased nutrient absorption in the gastrointestinal tract, which accounts for concomitant weight loss. However, the overall loss of lean body tissue observed in patients with cachexia occurs independent of nutrient uptake.
Cachexia is a syndrome characterized by the loss of lean body tissue, often including involuntary weight loss, accompanied by increased metabolic and proinflammatory cytokine activity. It is distinct from mere weight loss due to anorexia and from sarcopenia, which is characterized by the loss of
Diagnosis The multifactorial etiology and absence of a consensus definition for cachexia presents challenges to diagnostic uniformity. Most current diagnostic systems for cachexia assess at least some of the following: (1) percentage of unintentional body weight lost in a specific time frame (e.g., the past 12 months); (2) proportion of lean body mass to fat mass; (3) body mass index; (4) the presence of clinical symptoms such as
Cachexia (Wasting Syndrome) Travis Lovejoy Mental Health & Clinical Neurosciences Division, Portland Veterans Affairs Medical Center, Portland, OR, USA
Synonyms AIDS wasting; Cancer cachexia; cachexia; HIV wasting; Slim disease
Definition
M.D. Gellman & J.R. Turner (eds.), Encyclopedia of Behavioral Medicine, DOI 10.1007/978-1-4419-1005-9, # Springer Science+Business Media New York 2013
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decreased muscle strength, fatigue, and decreased appetite; and (5) abnormal biochemistry such as increased inflammatory markers. Treatment Treatments for cachexia aim to restore lean body mass and improve quality of life. Pharmacological treatments have focused on (1) increasing appetite and caloric intake through the use of appetite stimulants; (2) maintaining and/or restoring lean body mass with testosterone, anabolic steroids, or human growth hormone; and (3) downregulating cytokine activity through the use of systemic antiinflammatory medications. Non-pharmacological treatments include resistance training for muscle retention, nutritional counseling and supplementation to ensure adequate macro- and micronutrient intake, and targeted amelioration of conditions that may exacerbate cachexia such as opportunistic infections in those with compromised immune systems. Psychosocial Impact of Wasting Although cachexia has a gradual onset, its clinical m
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