Nutrition
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Sarcopenia has been reported as a prognostic risk factor in patients with gastrointestinal (GI) and hepatobiliary pancreatic (HBP) cancers. This study aimed to investigate whether the loss of muscle mass or strength is a stronger prognostic factor, and explore the cutoff values of skeletal muscle mass index (SMI) and handgrip strength (HGS) based on the survival outcome in patients with GI and HBP cancers. ⋯ Low muscle strength was a stronger prognostic factor than low muscle mass. Therefore, measuring muscle strength in all patients is essential.
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The aim of this study was to evaluate the effects of trunk muscle mass on functional prognosis, including activities of daily living (ADLs), at hospital discharge in patients with acute stroke. ⋯ Trunk muscle mass is associated with ADLs at hospital discharge after acute stroke. TMI is important for evaluating functional prognosis in patients with acute stroke.
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Visceral obesity, assessed using the visceral adiposity index (VAI), is related to mortality, but studies of populations with chronic kidney disease (CKD) are scarce. The aim of this study was to evaluate the relationship between VAI and all-cause mortality among individuals with CKD. ⋯ Visceral obesity may influence the rate of all-cause mortality in a nonlinear manner in populations with CKD. Risk for death was higher with visceral fat deficiency than with excessive visceral fat deposition.
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Case Reports
Delayed appearance of refeeding syndrome in a patient with anorexia nervosa: A case report.
Refeeding syndrome (RFS) can be a severe and life-threatening complication of anorexia nervosa (AN) associated with electrolyte abnormalities and organ damage, and occurs with the transition from a prolonged catabolic to anabolic state, particularly with an overzealous nutrient supply. There is no unequivocal definition of RFS, although hypophosphatemia is recognized as a crucial factor in its pathogenesis. RFS can be responsible for cardiovascular complications, such as heart failure, left ventricular damage, and arrhythmias, because of different potential mechanisms: electrolyte imbalances, increased retention of sodium and liquids secondary to insulin secretion, and excessive fat emulsion supplementation. ⋯ A more pronounced water restriction protocol and delayed achievement of goal feeding rate, resulting also in lower sodium intake, were implemented to reduce cardiac overload with a full resolution of the complication in approximately 2 mo. Refeeding patients with AN could be complicated by heart failure despite cautious nutritional replenishment and regardless of electrolyte imbalance, even in a later phase of recovery. Therefore, strict adherence to recommendations for nutritional replenishment and close monitoring of cardiac function should always be considered when refeeding patients with AN.
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The presence of myosteatosis is one factor associated with poor prognosis for patients with cirrhosis; however, the factors contributing to worsening myosteatosis are, to our knowledge, unknown. The aim of this study was to clarify the changes in myosteatosis, and the factors involved in these changes. ⋯ In patients with cirrhosis, myosteatosis progressed, and decreases in SMI and increases in VFI were correlated with its progression.