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Lore Ceulemans

Bio: Lore Ceulemans is an academic researcher. The author has contributed to research in topics: Medicine & Airway. The author has an hindex of 1, co-authored 1 publications receiving 60 citations.

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Journal ArticleDOI
TL;DR: A correlation with prognosis in favour of Evans et al’ definition as a tool for cachexia diagnosis is presented, which means that weight loss and BMI decline are both key factors in patients with cancer leading to cachexia but less decisive as stated by Fearon et al.
Abstract: Objective This study aimed to provide evidence-based results on differences in overall survival (OS) rate to guide the diagnosis of cancer cachexia. Design Data collection and clinical assessment was performed every 3 months (5 visits): baseline data, muscle strength, nutritional and psychosocial status. 2 definitions on cachexia using different diagnostic criteria were applied for the same patient population. Fearon et al's definition is based on weight loss, body mass index (BMI) and sarcopenia. Evans et al nuances the contribution of sarcopenia and attaches additional attention to abnormal biochemistry parameters, fatigue and anorexia. The mean OS rates were compared between patients with and without cachexia for both definitions. Results Based on the population of 167 patients who enrolled, 70% developed cachexia according to Fearon et al's definition and 40% according to Evans et al's definition. The OS in the cachectic population is 0.97 and 0.55 years, respectively. The difference in OS between pat...

80 citations

Proceedings ArticleDOI
04 Sep 2022
TL;DR: In this article , the morphological changes of COPD by microCT (number of terminal bronchioles/TB, alveolar surface density and tissue density) in combination with the innate and adaptive immune response by cellular deconvolution of tissue RNA profiling was studied.
Abstract: Emphysema, chronic bronchitis and small airways destruction characterize COPD of which the chronology remains elusive. Our aim was to study the morphological changes of COPD by microCT (number of terminal bronchioles/TB, alveolar surface density and tissue density) in combination with the innate and adaptive immune response by cellular deconvolution of tissue RNA profiling. A total of 13 control (non-used donor) and 11 COPD (end-stage) explant lungs frozen at TLC were selected and of each 4 samples were imaged by microCT and underwent tissue RNA profiling (Ion Amplyseq Technology). MicroCT images were used to quantify the COPD samples in mild, moderate and severe based on tissue percentage (T%) and alveolar surface density, reflecting the degree of emphysema (Fig 1A). Normalized gene expression data were imputed in the xCell R package for cell type enrichment analysis into structural, innate and adaptive cells. TB already decreased in mild COPD cores (p=0.0059 vs control), while T% and alveolar surface density gradually decreased (Fig 1B). Innate (dendritic cells) and adaptive immune cells (Th cells, Tc cells and B cells) only appeared in moderate and severe COPD cores (Fig 1C). Within end-stage COPD lungs, terminal bronchioles decrease already in mild affected cores and prior to alveolar tissue destruction and innate/adaptive Immune response which starts in the moderate stage.
Journal ArticleDOI
TL;DR: In this paper , the authors studied heterogeneity in visible airway remodeling, ranging from little (bronchiolitic) to extensive bronchiectasis, and investigated if this remodeling is associated with a different type of small airway disease.
Journal ArticleDOI
TL;DR: In this article , the authors assess the current practice of lung metastasectomy for colorectal cancer metastases in high-volume referral centers, focusing on short and long-term outcomes.

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Journal ArticleDOI
TL;DR: This review covers the diagnosis, assessment, and treatment of cancer cachexia; the elements impeding the formulation of a standard management guideline; and future directions of research for the improvement and standardization of current treatment procedures.
Abstract: Cancer cachexia is a multi-factorial syndrome, which negatively affects quality of life, responsiveness to chemotherapy, and survival in advanced cancer patients. Our understanding of cachexia has grown greatly in recent years and the roles of many tumor-derived and host-derived compounds have been elucidated as mediators of cancer cachexia. However, cancer cachexia remains an unmet medical need and attempts towards a standard treatment guideline have been unsuccessful. This review covers the diagnosis, assessment, and treatment of cancer cachexia; the elements impeding the formulation of a standard management guideline; and future directions of research for the improvement and standardization of current treatment procedures.

129 citations

Journal ArticleDOI
TL;DR: SGA and GLIM criteria, especially with HGS, are useful tools to diagnose malnutrition and have a similar predictive value regarding six-month mortality in cancer inpatients.
Abstract: Protein-calorie malnutrition is very frequent in cancer patients and is associated with an increase in morbidity and mortality. Recently, the Global Leadership Initiative on Malnutrition (GLIM) criteria were proposed to standardize the diagnosis of malnutrition. Nevertheless, these criteria were not validated in prospective studies. Our objective is to determine the prevalence of malnutrition in cancer inpatients using different diagnostic classifications, including GLIM criteria, and to establish their association with length of stay and mortality. Hence, we designed a prospective study. Within the first 24 hours of admission to the Inpatient Oncology Unit, subjective global assessment (SGA) was carried out, and anthropometric data (body mass index (BMI), mid-arm circumference (MAC), arm muscle circumference (AMC), fat-free mass index (FFMI)) and hand grip strength (HGS) were obtained to assess the reduction of muscle mass according to GLIM criteria. Length of stay, biomarkers (albumin, prealbumin, C-reactive protein (CRP)), and in-hospital and six-month mortality were evaluated. Regarding the 282 patients evaluated, their mean age was 60.4 ± 12.6 years, 55.7% of them were male, and 92.9% had an advanced-stage tumor (17.7% stage III, 75.2% stage IV). According to SGA, 81.6% of the patients suffered from malnutrition (25.5% moderate malnutrition, and 56.1% severe malnutrition), and, based on GLIM criteria, malnutrition rate was between 72.2 and 80.0% depending on the used tool. Malnourished patients (regardless of the tool used) showed significantly worse values concerning BMI, length of stay, and levels of CRP/albumin, albumin, and prealbumin than normally nourished patients. In logistic regression, adjusted for confounding variables, the odds ratio of death at six months was significantly associated with malnutrition by SGA (odds ratio 2.73, confidence interval (CI) 1.35–5.52, p = 0.002), and by GLIM criteria calculating muscle mass with HGS (odds ratio 2.72, CI 1.37–5.40, p = 0.004) and FFMI (odds ratio 1.87, CI 1.01–3.48, p = 0.047), but not by MAC or AMC. The prevalence of malnutrition in advanced-stage cancer inpatients is very high. SGA and GLIM criteria, especially with HGS, are useful tools to diagnose malnutrition and have a similar predictive value regarding six-month mortality in cancer inpatients.

125 citations

Journal ArticleDOI
18 Jul 2019-Cells
TL;DR: The main purpose of this review is to analyze the possible pathogenesis of CRF and recommend future research that will clarify CRF pathogenesis and facilitate the formulation of new treatment options.
Abstract: Many cancer patients suffer from severe fatigue when treated with chemotherapy or radiotherapy; however, the etiology and pathogenesis of this kind of fatigue remains unknown. Fatigue is associated with cancer itself, as well as adjuvant therapies and can persist for a long time. Cancer patients present a high degree of fatigue, which dramatically affects the quality of their everyday life. There are various clinical research studies and reviews that aimed to explore the mechanisms of cancer-related fatigue (CRF). However, there are certain limitations in these studies: For example, some studies have only blood biochemical texts without histopathological examination, and there has been insufficient systemic evaluation of the dynamic changes in relevant indexes. Thus, we present this narrative review to summarize previous studies on CRF and explore promising research directions. Plenty of evidence suggests a possible association between CRF and physiological dysfunction, including skeletal muscular and mitochondrial dysfunction, peripheral immune activation and inflammation dysfunction, as well as central nervous system (CNS) disorder. Mitochondrial DNA (mtDNA), mitochondrial structure, oxidative pressure, and some active factors such as ATP play significant roles that lead to the induction of CRF. Meanwhile, several pro-inflammatory and anti-inflammatory cytokines in the peripheral system, even in the CNS, significantly contribute to the occurrence of CRF. Moreover, CNS function disorders, such as neuropeptide, neurotransmitter, and hypothalamic-pituitary-adrenal (HPA) axis dysfunction, tend to amplify the sense of fatigue in cancer patients through various signaling pathways. There have been few accurate animal models established to further explore the molecular mechanisms of CRF due to different types of cancer, adjuvant therapy schedules, living environments, and physical status. It is imperative to develop appropriate animal models that can mimic human CRF and to explore additional mechanisms using histopathological and biochemical methods. Therefore, the main purpose of this review is to analyze the possible pathogenesis of CRF and recommend future research that will clarify CRF pathogenesis and facilitate the formulation of new treatment options.

112 citations

Journal ArticleDOI
TL;DR: The recent publication of the revised Consensus on definition and diagnosis of sarcopenia (EWGSOP2) and the Global Leadership Initiative on Malnutrition (GLIM) criteria changed the approach to research on sarcopenias and malnutrition as discussed by the authors.
Abstract: The recent publication of the revised Consensus on definition and diagnosis of sarcopenia (EWGSOP2) and the Global Leadership Initiative on Malnutrition (GLIM) criteria changed the approach to research on sarcopenia and malnutrition. Whilst sarcopenia is a nutrition-related disease, malnutrition and cachexia are nutritional disorders sharing the common feature of low fat-free mass. However, they have differential characteristics and etiologies, as well as specific therapeutic approaches. Applying the current definitions in clinical practice is still a challenge for health professionals and the potential for misdiagnosis is high. This is of special concern in the subgroup of older people with cancer, in which sarcopenia, malnutrition, and cancer cachexia are highly prevalent and can overlap or occur separately. The purpose of this review is to provide an updated overview of the latest research and consensus definitions of sarcopenia, malnutrition, and cachexia and to discuss their implications for clinical practice in older patients with cancer. The overall aim is to improve the quality of nutritional care in light of the latest findings.

60 citations

Journal ArticleDOI
TL;DR: The objective of this study was to establish sex‐specific cut‐off points for Chinese cancer patients and investigate the effect of low HGS on cancer mortality.
Abstract: BACKGROUND Handgrip strength (HGS) is associated with poor clinical outcomes, including all-cause, non-cardiovascular, and cardiovascular mortalities. The published cut-off points for HGS are mostly based on community populations from Western countries, lacking information on cancer patients from China. The objective of this study was to establish sex-specific cut-off points for Chinese cancer patients and investigate the effect of low HGS on cancer mortality. METHODS We did a retrospective cohort study of patients who were diagnosed with malignant cancer from June 2012 to December 2018. HGS was measured using a hand dynamometer in 8257 cancer patients. Optimal stratification was used to solve threshold points. The hazard ratio (HR) of all cancer mortality and cancer-specific mortality was calculated using Cox proportional hazard regression models. RESULTS Among all participants, there were 3902 (47.3%) women and 4355 (52.7%) men. The median age was 58 years old. The cut-off points of HGS to best classify patients with respect to time to mortality were <16.1 kg for women and <22 kg for men. Low HGS was associated with overall cancer mortality in both women and men [HR = 1.339, 95% confidence interval (CI) = 1.170-1.531, P < 0.001; HR = 1.346, 95% CI = 1.176-1.540, P < 0.001, respectively]. For specific cancer types, low HGS was associated with breast cancer (HR = 1.593, 95% CI = 1.230-2.063, P < 0.001) in women, and lung cancer (HR = 1.369, 95% CI = 1.005-1.866, P = 0.047) and colorectal cancer (HR = 1.399, 95% CI = 1.007-1.944, P = 0.045) in men. CONCLUSIONS On the basis of our sex-specific cut-off points, low HGS was strongly associated with cancer mortalities. These results indicate the usefulness of HGS measurement in routine clinical practice for improving patient assessments, cancer prognosis, and intervention.

52 citations