1.
[Betel - the fourth most popular substance in the world].
Zdrojewicz, Z, Kosowski, W, Królikowska, N, Stebnicki, M, Stebnicki, MR
Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 2015;(231):181-5
Abstract
Betel is a kind of substance for chewing, that is made from piper betle, areca nuts and other, additional constituents. It is the fourth most popular psychoactive substance in the world, right after caffeine, nicotine and alcohol. It is particularly famous in Asia. Betel chewing induces euphoria and it is addictive. Similarly like in other substances such as nicotine or alcohol, betel also has detrimental effects. It causes e.g. oral cancer and cancer of the oesophagus, it contributes to the development of metabolic syndrome, liver cirrhosis and chronic kidney disease. There are also positive effects of chewing betel, because is has antioxidant, anti-inflammatory, antyparasitic and antiseptic properties. The aim of this paper was to expand knowledge about betel and its both: positive and negative influence on human health. In this article original and review papers associated with the topic were used.
2.
Refeeding syndrome--awareness, prevention and management.
Mehanna, H, Nankivell, PC, Moledina, J, Travis, J
Head & neck oncology. 2009;:4
Abstract
BACKGROUND Refeeding syndrome is an important, yet commonly overlooked condition affecting patients. It occurs when feeding is commenced after a period of starvation. Head and neck cancer patients are at particular risk owing to prolonged periods of poor nutritional intake. This may be from general effects such as cancer anorexia or from more specific problems of dysphagia associated with this group of patients. Awareness of the condition is crucial in identifying patients at risk and taking measures to prevent its occurrence. OBJECTIVES The aims of this review are to: 1) Highlight the condition and stress the importance of its consideration when admitting head and neck cancer patients. 2) Discuss the pathophysiology behind refeeding syndrome. 3) Review the literature for the best available evidence and guidelines. 4) Highlight the need for further high quality research. CONCLUSION Refeeding syndrome is potentially fatal, yet is preventable. Awareness and identification of at-risk patients is crucial to improving management. Refeeding syndrome is caused by rapid refeeding after a period of under-nutrition, characterised by hypophosphataemia, electrolyte shifts and has metabolic and clinical complications. High risk patients include the chronically under-nourished and those with little intake for greater than 10 days. Patients with dysphagia are at particular risk. Refeeding should commence at 10 kcal/kg per day in patients at risk, and increased slowly. Thiamine, vitamin B complex and multi-vitamin supplements should be started with refeeding. New NICE guidelines state that pre-feeding correction of electrolyte and fluid deficits is unnecessary, but should be done concurrently with re-feeding. More research in this field is needed as the evidence base is lacking.
3.
Preoperative nutritional support at home in head and neck cancer patients: from nutritional benefits to the prevention of the alcohol withdrawal syndrome.
Bertrand, PC, Piquet, MA, Bordier, I, Monnier, P, Roulet, M
Current opinion in clinical nutrition and metabolic care. 2002;(4):435-40
Abstract
PURPOSE OF REVIEW Preoperative nutritional support in severely malnourished patients decreases complications after major surgery. This review summarizes previous studies on head and neck cancer patients undergoing surgery, and offers recommendations on preoperative nutritional support based on the literature and our experience. RECENT FINDINGS Head and neck cancer has a large impact on the patient's quality of life and a high mortality rate. Aggressive surgical resection followed by soft-tissue and osseous reconstruction is the gold standard of treatment. The incidence of postoperative complications is high at 20-50%. Malnutrition and alcohol withdrawal syndrome are often present, and are considered risk factors for developing wound infection after head and neck cancer surgery. Proactive intervention by preoperative nutritional support may correct nutrient deficiencies, minimize malnutrition-related morbidity and mortality, reduce the length and cost of hospitalization, and may prevent alcohol withdrawal syndrome. Nutritional support given preoperatively for 7-10 days decreases postoperative complications by approximately 10% in malnourished patients with weight loss of 10% or more. Oral liquid supplements and enteral nutrition are useful to support head and neck cancer patients preoperatively. Enteral nutrition is safer, more physiological, less expensive and practicable at home compared with parenteral nutrition, which is not usually indicated in these patients. SUMMARY Enteral nutrition is efficient in preoperative phase to prevent postoperative complications. However evidence is insufficient to conclude that preoperative immune-enhancing enteral feeding provides any supplementary benefit by comparison with a standard diet. Our experience with the preoperative approach in head and neck cancer patients is reported in this paper.