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Role of diet, physical activity and new drugs in the primary management of cancer cachexia in gastrointestinal tumors - a comprehensive review.

Cancer cachexia is a multifactorial syndrome characterized by involuntary weight loss, muscle mass reduction, and systemic inflammatory response, negatively impacting the quality of life and survival of cancer patients. In gastrointestinal tumors, cachexia prevalence can reach up to 80%, presenting a complex clinical challenge. This review aims to explore the efficacy of a multimodal approach integrating nutritional support and physical activity in cancer cachexia management. Targeted dietary strategies, such as a high-protein diet enriched with omega-3 and branched-chain amino acids (BCAAs), …

Targeting Asparagine Metabolism in Solid Tumors.

Reprogramming of energy metabolism to support cellular growth is a "hallmark" of cancer, allowing cancer cells to balance the catabolic demands with the anabolic needs of producing the nucleotides, amino acids, and lipids necessary for tumor growth. Metabolic alterations, or "addiction", are promising therapeutic targets and the focus of many drug discovery programs. Asparagine metabolism has gained much attention in recent years as a novel target for cancer therapy. Asparagine is widely used in the production of other nutrients and plays an important role in cancer development. Nutritional in

Growth Restriction Beginning in Early Infancy Among Survivors of Congenital Diaphragmatic Hernia: A Single-Center Experience.

A significant number of congenital diaphragmatic hernia (CDH) survivors experience growth restriction (GR), but the timing of its onset is not well studied. This single-center retrospective study evaluated the frequency of GR at specific postnatal ages and associated risk factors. We reviewed charts of prenatally diagnosed CDH patients delivered between 2011 and 2020, with follow-up until December 2022. Body height and weight Z-scores were assessed at 1, 2, 3, 6, 12, 18, and 36 months of age. GR, defined as a Z-score below -2.0, was observed in 32%, 63%, 50%, 50%, 48%, 42%, and 24% of patients

Fertility in Celiac Disease: The Impact of Gluten on Male and Female Reproductive Health.

Celiac disease (CeD) is a chronic immune-mediated disorder of the small intestine triggered by the ingestion of dietary gluten. This narrative review aims to summarize and critically evaluate the recent literature on the association between CeD and infertility, with an emphasis on identifying patterns and inconsistencies. Previous studies have reported conflicting findings: while some demonstrate a higher prevalence of unexplained infertility in patients with CeD, others do not support this association. Overall, untreated CeD may be a contributing factor to infertility, especially unexplained

Ectrodactyly, Cleft Lip/Palate, and Urinary Anomalies With a Tumor Protein p63 (TP63) Mutation: A Case Report and Literature Review.

Heterozygous mutations in the tumor protein p63 (TP63) gene underlie a spectrum of autosomal dominant syndromes, affecting ectodermal, limb, … The infant's abnormalities required multidisciplinary management, including surgical, urologic, and nutritional support. Our findings emphasized the markedly variable expression associated with TP63-related disorders. The father, despite carrying the same mutation, exhibited only a milder clinical presentation. Early genetic diagnosis was crucial for tailored managem …

Impact of Severe Sarcopenia on Depressive Symptoms and Quality of Life in Community-Dwelling Older Adults With Dementia: A Cross-Sectional Study.

PURPOSE: To examine the impact of sarcopenia severity on depressive symptoms and quality of life (QoL) among community-dwelling older adults … sarcopenia screening to guide interventions aimed at improving QoL, such as resistance training and nutritional support.

Clinical significance of imeglimin in older patients with type 2 diabetes: Analysis of a national database and a long-term case suggesting the potential for sarcopenia prevention.

We aimed to evaluate the clinical significance of imeglimin in older patients with type 2 diabetes. Prescription trends were analyzed using the National Database of Health Insurance Claims and Specific Health Checkups of Japan (2021-2023). Prescriptions for imeglimin increased, with the highest usage among patients in their 70s, followed by those in their 60s, and a clear upward trend in those aged ≥ 80 years. We present the case of an 80-year-old woman with diabetes who repeatedly discontinued treatment. After initiating imeglimin (2000 mg/day), she continued therapy successfully, achieving s

Comprehensive Review of Sepsis-Related Skeletal Muscle Atrophy: Mechanisms, Diagnosis and Therapeutic Strategies.

This comprehensive review aims to synthesize current evidence on sepsis-related skeletal muscle atrophy, with a focus on underlying mechanis … ng biomarkers including urinary titin and myokines are discussed. Treatment strategies encompassing nutritional support, pharmacotherapy (eg, GLP-1RAs, myostatin inhibitors), and rehabilitation are evaluated. Controversies regarding etiology and treatment efficacy are highlighted. Future directions include the exploration of novel biomarkers, genomics-based personali …

Endoscopic Vacuum-Assisted Closure for Radiation-Induced Laryngotracheoesophageal Fistula.

Radionecrosis can occur in any irradiated area of the head and neck, and when it involves the laryngotracheal region, it may lead to a laryn … endoluminal vacuum-assisted closure (EVAC) was applied instead. EVAC, combined with antibiotics and nutritional support, successfully closed the fistula, allowing the patient to resume a normal diet. This case demonstrates that EVAC is a feasible method for treating laryngotracheal fistula while preserving laryngeal function with minimal complications.

Advances and challenges in diagnosing and managing adult autoimmune enteropathy.

Autoimmune enteropathy (AIE) is a rare immune mediated disorder primarily affecting children, characterized by chronic diarrhea, malabsorpti … on using corticosteroids, calcineurin inhibitors, and anti-tumor necrosis factor therapy, alongside nutritional support. Despite the challenges, understanding AIE's diverse manifestations and improving diagnostic criteria are essential for effective management and improved patient outcome. Further research is needed to elucidate the pathogenesis, disease progression …

Conversion for Severe Malnutrition After Single Anastomosis Duodeno-Ileostomy with Sleeve Gastrectomy (SADI-S) to Duodenojejunal Bypass (DJB): a Case Series and Literature Review.

Single Anastomosis Duodeno-ileostomy with Sleeve Gastrectomy (SADI-S) is an emerging bariatric procedure that can sometimes lead to severe malnutrition. This report describes two cases of conversion surgery for post-SADI-S malnutrition and reviews management strategies. Both patients, who had undergone sleeve gastrectomy followed by SADI-S for weight recurrence, developed severe protein-energy malnutrition with hypoalbuminemia (1.6-1.8 g/dL) requiring parenteral nutrition, which normalized following conversion surgery. They underwent laparoscopic conversion to Roux-en-Y duodenojejunal bypass w

Persistent Refractory Headaches Following Non-alcoholic Wernicke's Encephalopathy in a Teenager.

Wernicke's encephalopathy (WE) is a neurological condition that presents with a clinical triad of ophthalmoparesis with nystagmus, confabulation, and ataxia. It is caused by thiamine deficiency (Vitamin B1), commonly associated with chronic alcoholism as well as non-alcoholic causes, and early diagnosis with prompt thiamine replacement is essential to prevent irreversible neurological damage. We report the case of a 17-year-old girl who lost 18 kg in one month due to aggressive dietary control without appropriate nutritional support and developed neurological signs that were consistent with WE…

Assessment of Health-Related Behaviors in Patients Hospitalized with Chronic Psychiatric Disorders-A Case-Control Study from a Closed Psychiatric Ward.

BACKGROUND: Severe psychiatric disorders are frequently associated with disruptions in health-related behaviors, including diet and lifestyle. This cross-sectional study aimed to assess and compare selected dietary and lifestyle behaviors among long-term psychiatric inpatients diagnosed with unspecified dementia (F03) or organic delusional disorder (F06.2) and a control group of mentally healthy individuals. METHODS: A 50-item validated questionnaire was administered to 28 hospitalized patients and 10 control participants. Analyses included nutritional habits, physical activity, stimulant use

Fulminant Phlegmonitis of the Esophagus and Stomach.

Phlegmonous esophagogastritis is a rare and life-threatening condition characterized by purulent inflammation of the submucosal and muscular … s, and cytomegalovirus co-infections. Despite intensive therapy, including antibiotics, antivirals, nutritional support, and pleural drainage, the patient's condition deteriorated, leading to multi-organ failure and death. This case highlights the diagnostic challenges posed by nonspecific symptoms of phlegmonous esophagogastritis, the critical importance of early en …

Mycobacterium wolinskyi Bloodstream Infection Associated With a Central Venous Port: A Case Report.

Mycobacterium wolinskyi is a rapidly growing non-tuberculous Mycobacterium typically associated with surgical wounds or implanted devices. We report an elderly woman with a central venous (CV) port inserted two years earlier for long-term nutritional support after gastric cancer surgery who developed a bloodstream infection caused by M. wolinskyi. Gram staining of the positive blood culture revealed slender filamentous Gram-positive rods, prompting suspicion of rapidly growing mycobacteria (RGM). The organism isolated from both blood and port cultures was identified by matrix-assisted laser de…

Disrupted Prenatal Metabolism May Explain the Etiology of Suboptimal Neurodevelopment: A Focus on Phthalates and Micronutrients and their Relationship to Autism Spectrum Disorder.

Pregnancy is a time of high metabolic coordination, as maternal metabolism adapts to support the growing fetus. Many of these changes are coordinated by the placenta, a critical fetal endocrine organ and the site of maternal-fetal crosstalk. Dysregulation in maternal and placental metabolism during pregnancy has been linked to adverse outcomes, including altered neurodevelopment. Autism spectrum disorder (ASD) is a neurodevelopmental disorder linked to metabolic alterations in both children and their mothers. Prenatal environmental exposures have been linked to risk of ASD through dysregulated

Cardiovascular Concerns, Cancer Treatment, and Biological and Chronological Aging in Cancer: JACC Family Series.

Cardiovascular disease (CVD) and cancer are leading causes of death globally, particularly among the rapidly growing population of older adults (OAs). CVD is a leading cause of mortality among cancer survivors, often accelerated by cancer treatments associated with short- or long-term cardiotoxicity. Moreover, there is a dynamic relationship among CVD, cancer, and aging, characterized by shared risk factors and biological hallmarks, that plays an important role in caring for OAs, optimizing treatment approaches, and developing preventive strategies. Assessment of geriatric domains (eg, functio

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… GA also leads to nononcologic interventions aimed at addressing vulnerabilities, including polypharmacy, nutritional support, optimizing comorbidities, and social interventions. …

[Review and prospects of international clinical research in critical care medicine in 2023].

The main clinical research advances of critical care in 2023 includes: new trials of Chinese herbal medicine, hydroxocobalamin (vitamin B12) … tension), blood pressure targets after successful stroke thrombectomy (intensive/conventional), and nutritional support strategies (low protein-calories/conventional protein-calories, fasting/persistent feeding before extubation). Thus, given above progress, carrying out high -quality domestic multi-center clinical registration researches, constructing shareable stan …

A Case of Life-Threatening Postpartum Necrotizing Pancreatitis Requiring Gastrocystostomy With Serial Pancreatic Necrosectomies.

We present a life-threatening case of postpartum acute necrotizing pancreatitis. The patient is a 37-year-old female with no past medical history who delivered a healthy baby boy via cesarean section. Twenty days later, she presented to the emergency department with acute onset of nausea, non-bloody vomiting, abdominal bloating, and epigastric pain radiating to the back. Less than 24 hours later, she progressed into septic shock despite aggressive resuscitation, requiring vasopressor support in the ICU. Initial CT imaging showed multiple patchy hypodensities throughout the pancreas consistent

Combination of Percutaneous Endoscopic Gastrostomy and Lumboperitoneal Shunt: A Case Report.

The combination of percutaneous endoscopic gastrostomy (PEG) and cerebrospinal fluid (CSF) shunt surgery presents unique challenges in managing shunt-related infections. Although the association between PEG and ventriculoperitoneal (VP) shunt surgery is well documented, studies on the combination of PEG and lumboperitoneal (LP) shunt surgeries are limited. We report the case of a 70-year-old man who developed hydrocephalus after decompressive craniectomy for ischemic stroke. The patient required PEG for nutritional support and an LP shunt for CSF drainage. PEG was initially performed. After 16…