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Computed tomography (CT) of the head showed multiple skull fractures, bilateral epidural haematoma, a right subdural haematoma and subarachnoid haemorrhage. One week after the positive blood culture, the patient's liver function had deteriorated considerably, with an aspartate aminotransferase of 515 u/L, alkaline phosphatase of 315 u/L and alanine aminotransferase of 183 u/L. Unfortunately, he deteriorated rapidly and expired 89 days after hospital admission. This patient, who suffered concomitant fatal traumatic brain injury, emphasises the value of peripheral blood morphology, blood culture and mass spectrometry in the diagnosis of I Pandoraea apista i bacteraemia. [Extracted from the article]

A blood count showed WBC 2.97 × 10 SP 9 sp /l, haemoglobin concentration 61 g/l and platelets 38 × 10 SP 9 sp /l. A peripheral blood film revealed no blasts or dysplasia. A bone marrow (BM) aspirate showed 12% blasts. [Extracted from the article]

Background: Dietary education and modification interventions are valuable and feasible strategies for enhancing nutritional status and managing symptoms in patients with gastric cancer following gastrectomy. In alignment with administrative policies prioritizing shorter hospital stays and enhanced postoperative self-management, the provision of a simplified nutritional management approach following gastrectomy holds promise for preventing weight loss and expanding resources for monitoring both the nutritional and symptomatic aspects of these patients., Objective: This study evaluated the effectiveness of an integrative approach involving the five sequential steps of Conversation, Assessment, Nutrition plan, Complications, Evaluation, and Reassurance or Removal (CANCER) into Altering Intake and Managing Symptoms (AIMS), with specific focus on enhancing nutritional status and symptom management., Design: A single-blind, two-arm, randomized controlled trial., Setting: This study was conducted at a tertiary hospital in Shandong province, China., Participants: Patients with total or subtotal gastrectomy for gastric cancer., Methods: The participants were randomly assigned to either the intervention or control group in a 1:1 ratio. The intervention group received a 16-week CANCER-AIMS intervention program. The control group received usual routine care dietary guidance. Questionnaires and electronic medical records of each patient were used to assess dietary intake, dietary symptoms, and subjective and objective nutritional status. Outcomes were assessed at four specific time points: the day before discharge and at 4-, 8-, and 16-weeks following hospital discharge., Results: Thirty-eight participants completed the study. The findings revealed significant interaction effects between group and time for dietary intake, dietary symptoms, and nutritional status between intervention and control groups (P < 0.001). The intervention group had significantly higher dietary intake, fewer dietary symptoms, and better nutritional status post-intervention than the control group (P < 0.001). Moreover, there were significant differences in dietary intake, dietary symptoms, and nutritional status according to time in both the intervention and control groups., Conclusion: The CANCER-AIMS intervention for patients with gastric cancer following gastrectomy may be efficient at enhancing nutritional intake, reducing negative dietary symptoms, and thus improving both their subjective and objective nutritional status., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)