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Aims:The aim of this paper was to update the evidence-based practice guidelines for the nutritional management of patients receiving radiation therapy and broaden the scope to include chemotherapy. Methods: The following databases were searched using a range of keywords: Cochrane Database, CENTRAL, MEDLINE (via Ebscohost), EMBASE, CINAHL (Ebscohost), Web of Science, Health Source: Nursing/Academic Edition and PubMed. Relevant papers (n = 47) were reviewed by at least two members of the steering committee and assigned a level of evidence and a quality rating. Results: There were no new published randomised controlled trials (RCTs) of nutrition intervention in radiation therapy. Most statements in the previous radiation therapy guidelines have strong evidence supporting nutrition intervention. There were 12 studies in chemotherapy including five RCTs. While these studies provided strong evidence that simple nutrition intervention improves nutritional outcomes such as dietary intake and weight, they did not find an improvement in quality of life or survival. Several RCTs found no benefits of nutrition support in patients undergoing chemotherapy. None of the RCTs in chemotherapy used medical nutrition therapy (MNT) as the intervention, but rather simple dietary advice and/or supplements. Conclusions:The evidence to support nutrition intervention in patients receiving radiation therapy remains strong. However, the benefits of nutrition intervention in chemotherapy are less clear. Further studies are required to evaluate the impact of MNT as opposed to simple dietary advice in chemotherapy patients. This update contributes to a move towards comprehensive evidence-based guidelines for the nutritional management of patients with cancer.

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Background: With no long-term data available in published research to date, this study

Hydrocephalus is a common and potentially devastating birth defect affecting the CNS, and its relationship with G protein-coupled receptors (GPCRs) is unknown. We have expressed 2, 4, or 6 copies of a GPCR--the human PAC1 receptor with a 130-kb transgene in the mouse nervous system in a pattern closely resembling that of the endogenous gene. Consistent with PAC1 actions, PKA and PKC activity were elevated in the brains of Tg mice. Remarkably, Tg mice developed dose-dependent hydrocephalus-like characteristics, including enlarged third and lateral ventricles and reduced cerebral cortex, corpus callosum, and subcommissural organ (SCO). Neuronal proliferation and apoptosis were implicated in hydrocephalus, and we observed significantly reduced neuronal proliferation and massively increased neuronal apoptosis in the developing cortex and SCO of Tg embryos, while neurite outgrowth and neuronal migration in vitro remain uncompromised. Ventricular ependymal cilia are crucial for directing cerebrospinal fluid flow, and ependyma of Tg mice exhibited disrupted cilia with increased phospho-CREB immunoreactivity. These data demonstrate that altered neuronal proliferation/apoptosis and disrupted ependymal cilia are the main factors contributing to hydrocephalus in PAC1-overexpressing mice. This is the first report to our knowledge demonstrating that misregulation of GPCRs can be involved in hydrocephalus-related neurodevelopmental disorders.

Patients with malnutrition and/or intake-limiting CINV and in need of improved nutrition symptom management may be overlooked, particularly patients who are overweight or obese-an increasing proportion of the Australian population. Evidence-based practice guidelines recommend implementing validated nutrition screening tools, such as the Malnutrition Screening Tool, in patients undergoing chemotherapy to identify those at risk of malnutrition who require dietitian referral.

Using a wiki platform for guideline development and dissemination is a successful method for producing high-quality resources that can undergo wide international stakeholder review and include open public consultation. This can replace conventional methods whereby guidelines can quickly become outdated.