Search

Cancer cachexia, characterized by the progressive loss of skeletal muscle mass, leads to functional impairment and poor prognosis. Anamorelin is approved for treating cancer cachexia in Japan; however, the factors influencing its discontinuation and the impact of combining anamorelin with rehabilitation remain unclear. Therefore, we retrospectively analyzed 82 patients with cancer cachexia to identify factors associated with anamorelin discontinuation and assess changes in nutritional status and motor function using non-dominant handgrip strength after 12 wk. Patients received outpatient rehabilitation, combining resistance and aerobic training every two weeks, alongside anamorelin therapy. Our findings indicate that patients with an ECOG performance status of 1 or 2 were less likely to continue anamorelin therapy for 12 wk compared to those with a performance status of 0 (odds ratio 2.71; 95% CI 1.05 − 7.00; p = 0.040). Significant improvements were observed in body weight (48.8 to 53.7 kg, p < 0.001), skeletal muscle mass (6.4 to 6.9 kg/m2, p < 0.001), FAACT score (11.5 to 18.0, p < 0.001), and non-dominant handgrip strength (20.5 to 21.7 kg, p = 0.018) after 12 wk. Early initiation of anamorelin with regular rehabilitation is recommended to enhance nutritional status and motor function in patients with cancer cachexia. [ABSTRACT FROM AUTHOR]

Guanylate cyclase C (GC‐C), a receptor expressed on the apical membrane of intestinal mucosal cells, is activated by heat‐stable enterotoxin (STa) produced by enterotoxigenic Escherichia coli, as well as the endogenous ligands guanylin and uroguanylin. In this study, novel peptides that interact with GC‐C were generated using the cDNA display method, and their binding affinity and biological activity were evaluated. While the linear peptide library did not yield peptides with sufficient affinity for GC‐C, three cyclic peptides (GCC‐P1, GCC‐P2, and GCC‐P3), each containing two cysteine residues within a 15‐residue sequence, were obtained from a cyclic peptide library containing nine‐residue random sequences. GC‐P2 exhibited significant binding affinity in Biacore assays, although the affinity was lower than those reported for known ligands. Notably, GCC‐P2 and GCC‐P3 demonstrated enhanced cGMP activity when used in combination with linaclotide. However, the agonist activity of these peptides was minimal, indicating that further modifications may be necessary to develop them for clinical applications. This study successfully extracted consensus sequences of peptide motifs that bind to GC‐C from a highly diverse nine‐residue random sequence library, which provides fundamental insights for the discovery and optimization of novel GC‐C ligands. [ABSTRACT FROM AUTHOR]

Introduction: Geriatric Nutritional Risk Index (GNRI) is a reliable index derived from serum albumin levels, height, and weight. Although various prognostic factors have been studied, the effect of preoperative nutritional status on surgical outcomes remains unexplored. This study aimed to evaluate the efficacy of the GNRI in predicting postoperative outcomes of lower gastrointestinal perforation. Methods: Eighty patients treated at our institution between January 2016 and December 2022 were retrospectively analyzed. This study primarily focused on the correlation between preoperative GNRI and two key outcomes: postoperative hospital stay duration and 1-year mortality rate. Results: Our findings revealed a significant association between low GNRI scores and increased 1-year mortality (odd ratio 4.0, 95% confidence interval [CI] 1.1–16, p = 0.025). Kaplan-Meier analysis and log-rank test showed that patients in the low GNRI group had markedly poorer overall survival rates than those in the high GNRI group (12-month survival rate 0.88 [95% CI: 0.75–0.95] vs. 0.65 [95% CI: 0.47–0.78]; p = 0.018). Additionally, both univariate and multivariate analyses indicated that lower GNRI scores were associated with prolonged hospital stays. Conclusion: We showed that a low GNRI score was associated with high mortality and prolonged hospital stay after emergency surgery for lower gastrointestinal perforation. [ABSTRACT FROM AUTHOR]

Cardiac tamponade is a rare postoperative complication of esophagectomy, with no previous reports of association with coronary artery aneurysm rupture. We present a case of cardiac tamponade caused by coronary aneurysm rupture following esophageal cancer surgery. A 68-year-old man with no history of heart disease underwent robotic subtotal esophagectomy for esophageal squamous cell carcinoma. He experienced intermittent chest pain on postoperative day (POD) 17. Echocardiography revealed increasing pericardial fluid, and pericardiocentesis on POD 34 revealed bloody pericardial fluid. Contrast-enhanced computed tomography and coronary angiography revealed a ruptured coronary aneurysm causing cardiac tamponade. Emergency surgery with a median sternotomy achieved hemostasis, and the patient recovered successfully. Cardiac tamponade after esophageal surgery, particularly from coronary aneurysm rupture, is rare. Prompt diagnosis and treatment are crucial for patient survival. Despite its risks, median sternotomy was effective in achieving rapid hemostasis and patient recovery in this case. [ABSTRACT FROM AUTHOR]