Acute Postoperative Changes in Body Composition and Muscle Function Among Patients with Pancreatic Cancer Undergoing Pancreaticoduodenectomy

Aim: To observe changes in the nutritional status of patients during the acute postoperativedays following pancreaticoduodenectomy and to evaluate their influence onpostoperative complications.Methods: Nutritional status was assessed in 72 patients on the preoperative day beforesurgery and postoperative days (PD) 3 and 8, included measurements of bodycomposition by bioimpedance impedance analysis, biochemical values and musclefunction by maximum handgrip strength (HGS). The presence of postoperative complicationswas collected over 30 post operative days. Changes at PD were calculatedfor all variables. Non-parametric statistics were used and results are given as median(25th–75th quartiles).Results : Significant changes occurred on PD 3 in body weight +2.3 (0.8–3.6) kg, totalbody water +2.8 (1.1–5.9) l, extracellular water +2.5 (1.2–3.7) l, intracellular water+1.1 (-0.4–1.9) l, phase angle -1.0 (-1.2 to -0.7)°, C-reactive protein +58.0 (36.0–100.8)mg/l, serum albumin -12 (-16.5 to -10.0) g/l, and HGS -4.8 (-7.3 to -3.0) kg. Higher butno significant changes were observed at PD 3 in patients with postoperative complications(n=28) compared to those without (n=44). The hospital stay was longer inpatients with complications (12.5 days, p=0.005).Conclusion: Changes in body composition, biochemical values and muscle functionwere observed during the first 8 PDs. Changes at PD 3 did not influence significantlythe outcomes, but trends in body fluids and phase angle were found among patientswith postoperative complications

The Complex Interplay between Immunonutrition, Mast Cells, and Histamine Signaling in COVID-19

There is an ongoing need for new therapeutic modalities against SARS-CoV-2 infection. Mast cell histamine has been implicated in the pathophysiology of COVID-19 as a regulator of proinflammatory, fibrotic, and thrombogenic processes. Consequently, mast cell histamine and its receptors represent promising pharmacological targets. At the same time, nutritional modulation of immune system function has been proposed and is being investigated for the prevention of COVID-19 or as an adjunctive strategy combined with conventional therapy. Several studies indicate that several immunonutrients can regulate mast cell activity to reduce the de novo synthesis and/or release of histamine and other mediators that are considered to mediate, at least in part, the complex pathophysiology present in COVID-19. This review summarizes the effects on mast cell histamine of common immunonutrients that have been investigated for use in COVID-19

Physiological Alterations in Relation to Space Flight: The Role of Nutrition

Astronauts exhibit several pathophysiological changes due to a variety of stressors related to the space environment, including microgravity, space radiation, isolation, and confinement. Space motion sickness, bone and muscle mass loss, cardiovascular deconditioning and neuro-ocular syndrome are some of the spaceflight-induced effects on human health. Optimal nutrition is of the utmost importance, and—in combination with other measures, such as physical activity and pharmacological treatment—has a key role in mitigating many of the above conditions, including bone and muscle mass loss. Since the beginning of human space exploration, space food has not fully covered astronauts’ needs. They often suffer from menu fatigue and present unintentional weight loss, which leads to further alterations. The purpose of this review was to explore the role of nutrition in relation to the pathophysiological effects of spaceflight on the human body

COVID-19 Disease and Outcomes among Critically Ill Patients: The Case of Medical Nutritional Therapy

The recent COVID-19 pandemic, which resulted from SARS CoV-2 coronavirus infection, contributed toa rapid increasein hospital and intensive care unit (ICU) admissions [...

The impact of body mass index on post resuscitation survival after cardiac arrest: A meta-analysis

Background: Observational studies examining the association between body mass index (BMI) and the outcome of cardiac arrest (CA) shows controversial results. Methods: We reviewed literature for studies assessing the impact of BMI on survival and neurological outcome following CA. Eligible studies were subsequently meta-analyzed and pooled odds ratios and their corresponding 95% confidence intervals for post CA survival and neurological status were derived. Results: A total of 7 studies with 24,651 patients were evaluable for this meta-analysis. The studies were also categorized by location of the CA and the use of therapeutic hypothermia. Our results suggested that BMI between 25 and 29.9 kgr/m2had a favorable impact on survival after CA (OR = 1.172, 95% CI, 1.109-1.236) in comparison to normal weight subjects. Likewise, overweight patients presented increased odds for a favorable neurological outcome after CA (OR = 1.112, 95% CI, 1.020-1.213). On the contrary, underweight subjects presented decreased odds of surviving after CA as compared to normal BMI subjects (OR = 0.781, 95% CI, 0.652-0.935). Finally, BMI >30 kgr/m2was not associated with improved survival or neurological outcome as compared to BMI 18.5-24.9 kgr/m2. Conclusions: Overweight patients have a favorable prognosis after CA in terms of both survival and neurological outcome. This effect was amplified when the analysis is restricted in in-hospital cardiac arrest and in patients non-treated with therapeutic hypothermia

Global Leadership Initiative on Malnutrition Criteria Predict Pulmonary Complications and 90-Day Mortality after Major Abdominal Surgery in Cancer Patients

Although several studies have reported an association between malnutrition and the risk of severe complications after abdominal surgery, there have been no studies evaluating the use of Global Leadership Initiative on Malnutrition (GLIM) criteria for predicting postoperative pulmonary complications (PPCs) following major abdominal surgery in cancer patients. This study aimed to investigate the association among the diagnosis of malnutrition by GLIM criteria, PPCs risk and 90-day all-cause mortality rate following major abdominal surgery in cancer patients. We prospectively analyzed 218 patients (45% male, mean age 70.6 ± 11.2 years) with gastrointestinal cancer who underwent major abdominal surgery at our hospital between October 2018 and December 2019. Patients were assessed preoperatively using GLIM criteria of malnutrition, and 90-day all-cause mortality and PPCs were recorded. In total, 70 patients (32.1%) were identified as malnourished according to GLIM criteria, of whom 41.1% fulfilled the criteria for moderate and 12.6% for severe malnutrition. PPCs were detected in 48 of 218 patients (22%) who underwent major abdominal surgery. Univariate logistic regression analysis revealed that the diagnosis of malnutrition was significantly associated with the risk of PPCs. Furthermore, in multivariate model analysis adjusted for other clinical confounding factors, malnutrition remained an independent factor associated with the risk of PPCs (RR = 1.82; CI = 1.21–2.73) and 90-day all-cause mortality (RR = 1.97; CI = 1.28–2.63, for severely malnourished patients). In conclusion, preoperative presence of malnutrition, diagnosed by the use of GLIM criteria, is associated with the risk of PPCs and 90-day mortality rate in cancer patients undergoing major abdominal surgery