Poor Nutritional Condition Research Articles

A Comparative Study on Growth Rates and Length-weight Relationships of Snow Trout (Schizothorax sp.) from Rasuwa, Nuwakot, and Okhaldhunga Districts of Nepal

Aims: Snow trout (Schizothorax spp.) are vital to Nepal's aquatic biodiversity and economy, yet little research has addressed their growth potential under controlled conditions. This study aimed to evaluate the growth performance of snow trout from three regions of Nepal (Okhaldhunga, Nuwakot, and Rasuwa) in captivity. Study Design: Original Research Article. Place and Duration of Study: Fisheries Research Station (FRS), Trishuli Nepal, between August 18 November 24, 2023. Methodology: Schizothorax species were collected from Okhaldhunga, Nuwakot, and Rasuwa districts and acclimated to the environment of the FRS in three separate raceways prior to the feeding trial. From each location, a population of 450 apparently healthy and uniform sized snow trout (initial weight: 20.00 + 1.2g) were then distributed into 3 raceway tanks, altogether 9 raceways for 3 groups, feeding upon the commercial feed (48% crude protein) in the form of dough at 3% of the body weight for 90 days. At the end of the feeding trial, growth parameters, including weight gain, specific growth rate (SGR), condition factor (K) and Length-weight relationship (LWR) were measured. Survival rate and water quality parameters were also measured. Statistical analysis for group’s means differences was conducted using one-way ANOVA in R Studio for Windows at a 5% level of significance. Results: Results indicated Fish from Nuwakot exhibited the highest weight gain (3.61 ± 1.82 g) and SGR (0.23 ± 0.12% per day), though these differences were not statistically significant (P >0.05). The condition factor (K) was highest for Rasuwa fish (0.98), followed by Nuwakot (0.97) and Okhaldhunga (0.97) (P >0.05), indicating that the fish were relatively thin, possibly due to poor nutrition or stressful conditions. The LWR analysis revealed high length-weight correlations for all groups, with Rasuwa fish exhibiting a positive allometric growth pattern (b=3.02), whereas Okhaldhunga (b=2.93) and Nuwakot (b=2.94) fish showed negative allometric growth patterns. This may suggest that snow trotu from Rasuwa were in relatively good physiological condition and adapting well to the rearing conditions at the FRS. Although with no statistical difference, the survival rate was highest for fish from Nuwakot (86.67%), followed by Rasuwa (80.00%) and Okhaldhunga (77.33%) (P >0.05). This may indicate the adequacy of the water quality (average temperature 11.75 ± 0.42℃, dissolved oxygen more than 7 mg/L, and pH 7.71 ± 0.16) maintained during the study. Conclusion: The findings suggest that while the snow trout demonstrated the ability to survive yet grow slowly under captivity, their growth performance may be significantly enhanced by optimizing rearing conditions, particularly slightly higher water temperature. This study underscores the need for targeted improvements in aquaculture practices to support the effective domestication and conservation of snow trout in Nepal.

PTH may predict early mortality in incident patients on hemodialysis: results from a large cohort.

Parathyroid hormone (PTH) is merit as a risk factor for mortality in patients with chronic kidney disease in prevalent hemodialysis patients in a U shape. Most studies, however, do not focus on incident patients and those who died within the first 90days of therapy. We evaluated PTH as a risk factor for mortality in a large cohort population in Brazil. This is an observational cohort study that included 4317 adult patients who initiated hemodialysis between July 1st, 2012 and June 30, 2017. The main outcome was all-cause mortality. Fine-gray sub-distribution hazard models were used to evaluate survival in the presence of a competing event (kidney transplant). Median PTH levels of 252 (118, 479) pg/mL. There were 331 deaths during the first 90days of therapy (6.7%), 430 in a 1-year follow-up (10.7%) and 1282 (32%) during the 5-year study period. Deaths according to PTH < 150, 150-600 and > 600pg/mL corresponded to 38.1%, 33.0% and 28.5%, respectively (p < 0.001). In an adjusted model, patients who started dialysis with PTH < 150pg/mL had a higher mortality risk within the first 90days, but not in 1year and 5years after starting dialysis. Analyses in a subset of patients with a repeated PTH in 1year (N = 1954) showed that although persistent PTH low levels (< 150pg/mL) at 1year were significantly associated with all-cause mortality, this result was not sustained after multiple adjustments. PTH < 150pg/mL confers a high mortality risk in the first 90days of dialysis. If this result reflects poor nutritional conditions, it deserves further investigations.

Sosialisasi Gizi dan Penyuluhan Keluarga Berencana Sebagai Upaya Menurunkan Angka Stunting di Desa Kemiri

Stunting is a chronic nutritional problem in young children that has serious implications for physical growth, cognitive development, and individual productivity. This condition is caused by a range of complex factors, including poor maternal nutrition and environmental conditions affecting quality of nutrition. The first 1,000 days of life represent a critical period for stunting prevention, as children's brain growth and development are particularly rapid during this time. Socialization regarding the importance of balanced nutrition and Family Planning programs is a strategic step to support optimal child growth and prevent stunting. This program begins with obtaining permits and coordinating with the Head of Kemiri Village to identify appropriate targets, as well as involving local neighborhood association in surveying facilities and infrastructure. The initiative aims to raise awareness in Kemiri Village about stunting and its prevention, and to educate the importance of balanced nutrition for supporting optimal child growth. Through socialization and counseling, it is hoped that the community will be able to recognize signs of stunting and take appropriate actions. This aligns with the village’s sustainable development goals (SDGs), particularly in achieving the target of a hunger-free village. By reducing the prevalence of stunting, the quality of life for the community can be significantly improved.

Candidiasis in Choloepus sp.-A Review of New Advances on the Disease.

Candidiasis is a significant fungal infection caused by various species of the genus Candida, posing health challenges to a wide range of animals, including Choloepus species (two-toed sloths). This review article aims to provide a comprehensive understanding of candidiasis in Choloepus sp., highlighting the etiology, epidemiology, pathogenesis, clinical manifestations, diagnosis, treatment, and prevention strategies. This article begins by examining the causative agents, primarily focusing on Candida albicans, which is the most commonly implicated species in candidiasis. The epidemiological aspects are discussed, emphasizing the prevalence of candidiasis in wild and captive Choloepus populations and identifying predisposing factors, such as immunosuppression, stress, poor nutrition, and environmental conditions. Pathogenesis is explored, detailing the mechanisms through which Candida species invade host tissues and evade immune responses. Clinical manifestations in Choloepus sp. are described, including oral thrush, cutaneous lesions, and gastrointestinal infections, and their impact on the health and behavior of affected individuals. Diagnostic methods, including culture techniques, histopathology, and molecular assays, are reviewed to highlight their roles in accurately identifying Candida infections. This article also covers treatment options, focusing on antifungal therapies and supportive care tailored to the unique physiology of Choloepus sp. Finally, prevention and management strategies are discussed, emphasizing the importance of maintaining optimal husbandry practices, regular health monitoring, and early intervention to reduce the incidence and impact of candidiasis in Choloepus populations. This review underscores the need for further research to enhance our understanding of candidiasis and improve health outcomes for these unique and vulnerable animals.

Transfer of micro-organisms from dry surface biofilms and the influence of long survival under conditions of poor nutrition and moisture on the virulence of Staphylococcusaureus

Biofilms on dry hospital surfaces can enhance the persistence of microorganisms on dry harsh clinical surfaces and can potentially act as reservoirs of infectious agents on contaminated surfaces. This study was conducted to quantify the transfer of viable Staphylococcus aureus cells from dry biofilms through touching and to investigate the impact of nutrient and moisture deprivation on virulence levels in S. aureus. Dry biofilms of S. aureus ATCC 25923 and a defective biofilm-forming ability mutant, S. aureus 1132 were formed in 24 well plates under optimised conditions mimicking dry biofilm formation on clinical surfaces. Microbial cell transfer was induced through the touching of the dry biofilms, which were quantified on nutrient agar. To investigate the impact of nutrient and moisture deprivation on virulence levels, dry and standard biofilms as well as planktonic cells of S. aureus ATCC 25923 were inoculated into Galleria mellonella and their kill rates compared. Results of this study showed that viable cells from dry biofilms of S. aureus ATCC 25923 were significantly more virulent and readily transferrable from dry biofilms through a touch test, therefore representing a greater risk of infection. The biofilm-forming capability of S. aureus strains had no significant impact on their transferability with more cells transferring when biofilm surfaces were wet. These findings indicate that dry biofilms on hospital surfaces may serve as a reservoir for the dissemination of pathogenic microorganisms in hospitals, thus highlighting the importance of regular cleaning and adequate disinfection of hospital surfaces.

A bioprinted sea-and-island multicellular model for dissecting human pancreatic tumor-stroma reciprocity and adaptive metabolism

Pancreatic ductal adenocarcinoma (PDAC) presents a formidable clinical challenge due to its intricate microenvironment characterized by desmoplasia and complex tumor-stroma interactions. Conventional models hinder studying cellular crosstalk for therapeutic development. To recapitulate key features of PDAC masses, this study creates a novel sea-and-island PDAC tumor construct (s&i PTC). The s&i PTC consists of 3D-printed islands of human PDAC cells positioned within an interstitial extracellular matrix (ECM) populated by human cancer-associated fibroblasts (CAFs). This design closely mimics the in vivo desmoplastic architecture and nutrient-poor conditions. The model enables studying dynamic tumor-stroma crosstalk and signaling reciprocity, revealing both known and yet-to-be-discovered multicellular metabolic adaptations. Using the model, we discovered the orchestrated dynamic alterations of CAFs under nutrient stress, resembling critical in vivo human tumor niches, such as the secretion of pro-tumoral inflammatory factors. Additionally, nutrient scarcity induces dynamic alterations in the ECM composition and exacerbates poor cancer cell differentiation—features well-established in PDAC progression. Proteomic analysis unveiled the enrichment of proteins associated with aggressive tumor behavior and ECM remodeling in response to poor nutritional conditions, mimicking the metabolic stresses experienced by avascular pancreatic tumor cores. Importantly, the model's relevance to patient outcomes is evident through an inverse correlation between biomarker expression patterns in the s&i PTCs and PDAC patient survival rates. Key findings include upregulated MMPs and key ECM proteins (such as collagen 11 and TGFβ) under nutrient-avid conditions, known to be regulated by CAFs, alongside the concomitant reduction in E-cadherin expression associated with a poorly differentiated PDAC state under nutrient deprivation. Furthermore, elevated levels of hyaluronic acid (HA) and integrins in response to nutrient deprivation underscore the model's fidelity to the PDAC microenvironment. We also observed increased IL-6 and reduced α-SMA expression under poor nutritional conditions, suggesting a transition of CAFs from myofibroblastic to inflammatory phenotypes under a nutrient stress akin to in vivo niches. In conclusion, the s&i PTC represents a significant advancement in engineering clinically relevant 3D models of PDAC masses. It offers a promising platform for elucidating tumor-stroma interactions and guiding future therapeutic strategies to improve patient outcomes.

Essentiality of dietary cholesterol and its interactions with phospholipid in juvenile slipper lobster (Thenus australiensis)

This study was conducted to verify the essentiality of dietary cholesterol for early juvenile slipper lobster, Thenus australiensis (initial weight 4.50 ± 0.72 g, mean ± SD, CV = 0.16), and to explore the potential for interactions between dietary cholesterol and phospholipid. An 8-week experiment was conducted using six experimental feeds containing three supplemental cholesterol concentrations (0, 0.2 and 0.4% dry matter) at two supplemental phospholipid concentrations (0% and 1.0% dry matter). Dietary cholesterol concentrations of ≥ 0.2% resulted in up to threefold greater weight gain compared to 0% dietary cholesterol, but without any significant main or interactive dietary phospholipid effect. An interaction was observed for lobster survival with lowest survival (46%) recorded for combined 0% cholesterol and 0% phospholipid compared to every other treatment (71–100%). However, all surviving lobsters at 0% dietary cholesterol, regardless of dietary phospholipid level, were in poor nutritional condition. Apparent feed intake (AFI) was significantly higher at dietary cholesterol ≥ 0.2% but was lower for each corresponding dietary cholesterol level at 1% dietary phospholipid. This implied that the feed conversion ratio was improved with supplemental phospholipid. In conclusion, this study confirms the essential nature of dietary cholesterol and that dietary phospholipid can provide additional benefits.

Spatial Clustering of Malnutrition and Anemia Among Reproductive Women and Its Associated Risk Factors in India: Evidence From National Family Health Survey-5.

Malnutrition and anemia are 2 severe public health concerns, predominantly in low-and middle-income nations. Malnutrition is defined as poor nutritional condition that encompass both under nutrition and over nutrition. The prevalence of overweight or obesity and anemia has increased in India from 2016 to 2021. The study aims to investigate the spatial clustering and factors responsible for underweight, overweight/obesity, and anemia among reproductive women (15-49 years) in India using the data from National Family and Health Survey-5 (2019-2021). We conducted hot-spot analysis using Moran's Index (MI) with the help spatial analysis software (i.e., GeoDa 1.18 and ArcGIS 10.8). It also demonstrates the autocorrelation. Multivariable logistic regression analysis has been performed to examine different determinants and risk associated with underweight, overweight/obesity, and anemia with various dependent variable by using Stata-14 software. Moran's Index for underweight (MI = 0.68), overweight/obesity (MI = 0.72), and anemia (MI = 0.62) indicates a high level of spatial-autocorrelation (P < .001) exists across the districts in India. As a result, a total of 156, 143, and 126 hot-spot districts are detected for underweight, overweight/obesity, and anemia, respectively. The burden of undernutrition and anemia is higher in rural areas. Risk of under nutrition and anemia are both reduced by media exposure and eating habits. Moreover, low income and low education level raises the risk of anemia and undernutrition, while obesity shows an inverse trend with income and education level. The study recommends targeting hot-spot districts for malnutrition and anemia, and policy level initiatives by addressing the responsible risk factors.

Pendidikan Kesehatan dalam Kelas Balita dan Pembuatan Makanan Pendamping ASI (MP ASI) di Posyandu Puskesmas Buaran Kota Pekalongan

Children under five are one of the populations most at risk of experiencing various health problems (illness) and death. The most common problem related to fulfilling toddler nutrition is lack of protein energy. The classification of toddlers includes: stunting (short body), thinness, and malnutrition. Poor nutritional conditions in toddlers can also cause child death. Approximately 45 (%) deaths among children under five are related to malnutrition. The aim of this activity is to provide benefits and make it easier for mothers of toddlers in choosing and giving MP-ASI to babies and toddlers. This activity uses the following methods: (a) Counseling about Mother Toddler Classes, (b) Counseling about the benefits of MP-ASI for toddlers, (c) Counseling about choosing a healthy MP-ASI menu, (d) Discussion and questions and answers. The results of the health education that has been carried out show an increase in the knowledge of mothers with toddlers about how to care for toddlers and make good complementary foods for breast milk with post test scores of 18 participants having good knowledge.

Spatio-temporal modeling of co-dynamics of smallpox, measles, and pertussis in pre-healthcare Finland.

Infections are known to interact as previous infections may have an effect on risk of succumbing to a new infection. The co-dynamics can be mediated by immunosuppression or modulation, shared environmental or climatic drivers, or competition for susceptible hosts. Research and statistical methods in epidemiology often concentrate on large pooled datasets, or high quality data from cities, leaving rural areas underrepresented in literature. Data considering rural populations are typically sparse and scarce, especially in the case of historical data sources, which may introduce considerable methodological challenges. In order to overcome many obstacles due to such data, we present a general Bayesian spatio-temporal model for disease co-dynamics. Applying the proposed model on historical (1820-1850) Finnish parish register data, we study the spread of infectious diseases in pre-healthcare Finland. We observe that measles, pertussis, and smallpox exhibit positively correlated dynamics, which could be attributed to immunosuppressive effects or, for example, the general weakening of the population due to recurring infections or poor nutritional conditions.

Relationship between nutritional condition and causes of death in beluga whales Delphinapterus leucas from the St. Lawrence estuary, Quebec, Canada.

Carcasses of endangered beluga whales Delphinapterus leucas from the St. Lawrence Estuary, Canada, have been examined consistently since 1983 to determine causes of death. The objective of this study is to compare the nutritional condition of belugas that died of different causes. Previously published categories of death were refined to discriminate acute from chronic pathological processes. Bayesian linear models were used to predict cause of death from the scaled mass index (SMI). Causes of death were as follows: 'bacterial diseases', 'verminous pneumonia', 'toxoplasmosis', 'other parasitic diseases', 'other infectious diseases', 'trauma-entrapment', 'other noninfectious diseases', 'dystocia-postpartum complications', 'neonatal mortality', 'cancer', 'primary starvation' and 'undetermined'. The models predicted a lower nutritional condition for the 'neonatal mortality' in belugas <290 cm in length and for 'primary starvation' and 'verminous pneumonia' categories for belugas ≥290 cm. Belugas that died from 'dystocia-postpartum complications' or from 'undetermined causes' had a higher-than-average SMI. Animals in the 'trauma-entrapment' category did not exhibit the highest nutritional condition, which was unexpected since individuals that died from trauma or entrapment are often used as references for optimal nutritional condition in other cetacean populations. Females that died from dystocia and postpartum complications were in similar nutritional condition as females dead from other causes during, or shortly after, pregnancy. This suggests that these females are not obese, ruling out a possible cause of dystocia. Although studying dead animals biases results toward low nutritional condition, our findings support the link between chronic pathological processes and poorer nutritional condition in belugas.

INFECTIOUS STOMATITIS IN CAPTIVE SALVATOR MERIANAE LIZARDS

Infectious stomatitis is a common ailment in captive reptiles, it arises from a combination of predisposing factors such as poor nutritional conditions, habitat issues or stress, where normal oral flora microorganisms act as pathogens, facilitating the disease development. This study aims to describe infectious stomatitis in a captive population of adult Salvator merianae lizards and to propose prophylactic measures for their maintenance in captivity. Within a population of 57 animals, a morbidity rate of 19.2% and a mortality rate of 7% were estimated. Microbiological analysis of oral mucosa revealed Pseudomonas aeruginosa susceptible to ceftazidime, ciprofloxacin, gentamicin, and amikacin. Symptoms ranged from asymptomatic to animals with mild oral cavity lesions or severe stomatitis, with some cases exhibiting respiratory complications. Histopathological examination of lung samples was consistent with caseous pneumonia. Intramuscular ceftazidime treatment and oral disinfection yielded excellent results for lizards with stomatitis, although a favorable response was not observed in animals with pneumonia.

Microbes control Drosophila germline stem cell increase and egg maturation through hormonal pathways

Reproduction is highly dependent on environmental and physiological factors including nutrition, mating stimuli and microbes. Among these factors, microbes facilitate vital functions for host animals such as nutritional intake, metabolic regulation, and enhancing fertility under poor nutrition conditions. However, detailed molecular mechanisms by which microbes control germline maturation, leading to reproduction, remain largely unknown. In this study, we show that environmental microbes exert a beneficial effect on Drosophila oogenesis by promoting germline stem cell (GSC) proliferation and subsequent egg maturation via acceleration of ovarian cell division and suppression of apoptosis. Moreover, insulin-related signaling is not required; rather, the ecdysone pathway is necessary for microbe-induced increase of GSCs and promotion of egg maturation, while juvenile hormone contributes only to increasing GSC numbers, suggesting that hormonal pathways are activated at different stages of oogenesis. Our findings reveal that environmental microbes can enhance host reproductivity by modulating host hormone release and promoting oogenesis.

NUTRITIONAL AND HEALTH STATUS OF TRIBAL PEOPLE: A REVIEW

Tribals have no fixed source of income and very little daily income. They are not regularly employed. They are not properly compensated. According to numerous studies, their economic and educational condition was insufficient. The majority of them were dependent on alcohol or tobacco and lived in mud-built homes. Several factors contribute to the poor nutritional condition of elderly people, including insufficient dietary iron, inadequate iron absorption, protein and micronutrient deficiencies, and infections. In a recent study, it was found that tribal people live an unfavorable lifestyle and are susceptible to respiratory, cutaneous, and other types of injuries. Low iron absorption, protein and micronutrient deficiencies, and infections lead to the poor nutritional status of the tribal people. In addition, tribal people are vulnerable to injuries, skin and respiratory problems, filarial diseases, and other illnesses due to their unfavorable lifestyles. According to the literature, various interventions, including nutrition and health promotion activities, are necessary to improve the occupational lifestyle of tribal people.

Application of Clustering-Based Data Mining for the Assessment of Nutritional Status in Toddlers at Community Health Centers

Nutritional status is a crucial foundation for human health and development. Global facts indicate serious challenges in ensuring adequate nutrition, and the situation is no different in Indonesia. This research collected data from the Kelapa Dua Tangerang community health center and utilized data mining techniques with the k-means clustering algorithm to delve deeper into the nutritional status of toddlers. The research findings revealed that nearly 37.3% of toddlers experience issues with abnormal height or weight, as well as poor nutritional conditions, highlighting the importance of careful and timely intervention. With regular health monitoring by community health centers and active parental involvement, actions can be taken to support the optimal growth and development of these children. The results of this research provide a strong understanding to address malnutrition issues, which will ultimately support the formation of a healthier and more promising future generation in Indonesia.

Effectiveness of implementation strategies to improve nutrition education interventions in adults living in rural and/or low-income communities.

The objective of this project was to promote evidence-based practice and identify how to best implement nutrition education interventions for adults living in rural and/or low-income communities. Adults living in rural and/or low-income communities are at increased risk for poor nutrition and chronic health conditions. Patients are referred to the EversCare Clinic (ECC), an ambulatory clinic at an academic medical center in Mississippi, USA, to receive assistance with social needs. In addition to living in rural and/or low-income communities, over 90% of the patients seen at the ECC are food-insecure, yet nutrition education is inconsistently provided. The JBI Practical Application of Clinical Evidence System (PACES) and the Getting Research into Practice (GRiP) audit and feedback tools were used. The ECC team conducted a baseline audit of 30 patient electronic health records, designed and implemented best-practice nutrition education strategies, and completed a follow-up audit of 30 patient electronic health records. Four evidence-based criteria for nutrition education in adults living in rural and/or low-income communities were audited, and various interventions were used to address multiple levels. The baseline audit revealed patients were not receiving recommended nutrition education interventions. Following the implementation, there was a 64.2% improvement in compliance with all four best practice criteria. Involving nursing students proved to be an effective method of improving compliance. Adherence to best practices regarding implementing nutrition education interventions was satisfactory, with 80% of patients receiving interventions at individual, interpersonal, community, and societal levels. Future audits are planned to ensure sustainability.

Isolation of Enterococcus faecium and determination of its mechanism for promoting the growth and development of Drosophila

Intestinal symbiotic microorganisms have a strong capacity to regulate the physiological functions of their host, and Drosophila serves as a useful model. Enterococcus faecium (E. faecium) is a member of the normal intestinal flora of animals. Lactic acid bacteria (LAB) such as E. faecium can promote the growth and development of Drosophila, but the mechanism of regulation of Drosophila is poorly understood. In this study, we found that E. faecium used a carbon source to produce probiotic acids. E. faecium is a symbiotic bacterium for Drosophila, and adult flies passed on parental flora to offspring. E. faecium promoted the growth and development of Drosophila, especially under poor nutritional conditions. E. faecium shortened the developmental process for Drosophila and accelerated the transformation from larva to pupa. Finally, E. faecium promoted the growth and development of Drosophila through TOR and insulin signalling pathways.

An Updated Review on Atrophic Rhinitis and Empty Nose Syndrome.

Objective: Atrophic rhinitis (AR) is a rare clinical condition affecting the nasal mucosa. It is characterized by progressive nasal congestion and thick, bothersome nasal secretions. In this narrative review, pathogenesis, differences between the 2 types of AR, new management modalities, and the impact of management on lifestyle have been highlighted. Materials and Methods: An extensive literature search was conducted using PubMed, Web of Science, Google Scholar, and Saudi Digital Library databases. The articles were investigated to extract information on the pathogenesis, types, new treatment modalities, and the impact of management on lifestyle. Results: AR has primary and secondary types that affect different populations and have specific clinical presentations. Primary AR is common in women and countries with long, warm seasons. Secondary AR is the most common disease in the industrialized world. It is more common among adults who have systemic disease, have undergone extensive nasal surgery, and have experienced nasal trauma. Certain infections, autoimmune disorders, chronic sinusitis, hormonal imbalance, poor nutritional condition, and iron deficiency anemia have been suggested as etiological factors. Conservative treatment is safe, inexpensive, and effective. Hygiene, a well-balanced diet, smoking cessation, and early detection and treatment of nasal pathology can help prevent AR. Some interventions shown to improve quality of life was explained in detail. Conclusions: This paper reviewed published relevant literature on AR related to pathogenesis, types, new treatment modalities, and the impact of treatment on lifestyle, thus, providing a comprehensive view of the management and prevention of AR.

Postoperative relative decrease in skeletal muscle mass as a predictor of quality of life in patients with gastric cancer.

Low skeletal muscle mass reflects poor nutritional condition, which may impair the functional status and quality of life (QOL) of survivors of gastrectomy. The present cross-sectional study examined the association between a relative change in skeletal muscle mass and perceived postoperative health and QOL in patients with gastric cancer. The study comprised 74 patients (48 men and 26 women; median age, 68.5 years) who underwent surgery for stage I-III gastric cancer. Outcomes were measured using the Postgastrectomy Syndrome Assessment Scale-45, which was specifically developed to measure post-gastrectomy symptoms, living status, dissatisfaction with daily life and generic QOL. The skeletal muscle mass index (SMI) was estimated using computed tomography by tracing the area of the psoas major muscle to calculate the ΔSMI, defined as: (SMI before surgery-SMI at completion of the PGSAS-45 survey)/SMI before surgery x100. Associations between ΔSMI and health outcomes were assessed using univariate and multivariate analyses. The mean ΔSMI (SD) was 8.64% (10.6%). The effect size (Cohen's d) of ΔSMI <10% compared with ΔSMI ≥10% was 0.50 (95% CI: 0.02 to 0.97) for total symptom scores, -0.51 (-0.98 to -0.03) for general health, and -0.52 (-0.99 to -0.05) for the physical component summary (PCS). Multiple regression analysis showed that ΔSMI was significantly associated with PCS decline, and its standardized regression coefficient was -0.447 (-0.209 to -0.685). Determining ΔSMI may help clinicians to facilitate the objective evaluation of low skeletal mass, which reflects poor nutritional condition that can impair functional status and QOL of postoperative patients surviving gastrectomy.

Postoperative delirium after cholecystectomy in older patients: A retrospective study.

Postoperative delirium (POD) is a common complication that increases mortality and morbidity in older patients. This study aimed to evaluate the clinical significance of post-cholecystectomy delirium in older patients. This retrospective study included 201 patients aged > 75 years who underwent cholecystectomy for acute or chronic cholecystitis between January 2016 and December 2019. Patients were divided into the POD (n = 21) and non-POD (n = 180) groups, and their demographic features and clinical results were compared. The mean patient age was 78.88 years; the female/male ratio was 44.8%/55.2%. Laparoscopic surgery was performed in 93.5% of patients. The univariate analysis showed that lower body mass index (BMI), immobilized admission status, neuropsychiatric disease history, preoperative intervention (percutaneous drainage), high C-reactive protein, hypoalbuminemia, neutrophilia, hypo-/hyperkalemia, and longer operative time were more frequently observed in the POD group. The multivariate analysis showed that lower BMI (odds ratio [OR], 2.796; p = 0.024), neuropsychiatric disease history (OR, 3.019; p = 0.049), hyperkalemia (OR, 5.972; p = 0.007), and longer operative time (OR, 1.011; p = 0.013) were significant risk factors for POD. POD was associated with inflammation degree, general condition, poor nutritional status, electrolyte imbalance, and stressful conditions. Recognizing risk factors requiring multidisciplinary team approaches is important to prevent and treat POD.