Myosteatosis is gathering attention as a feasible indicator for sarcopenia and increased risk of morbidity. However, the prognostic value of intramuscular adipose tissue content (IMAC) as an assessment method for myosteatosis remains controversial. The objectives of this study are to compare the prognostic value of intramuscular adipose tissue content (IMAC) with our newly-developed modified IMAC (mIMAC), and to assess the clinical significance of mIMAC in colorectal cancer (CRC) and gastric cancer (GC).

We evaluated 892 patients with CRC or GC, and assessed preoperative IMAC and mIMAC to compare their prognostic and predictive values for postoperative infectious complications in both cohorts.

Both preoperative IMAC and mIMAC were sex- and disease-dependent, and positively or negatively correlated with age in CRC and GC patients (IMAC CRC r=0.33, P<0.0001; GC r=0.304, P<0.0001; mIMAC CRC r=-0.364, P<0.0001; GC r=-0.263, P<0.0001). In contrast to IMAC, lower preoperative mIMAC was significantoth cohorts (CRC BMI r=0.193, P<0.0001; serum albumin r=0.42, P<0.0001; PNI r=0.39, P<0.0001; GC BMI r=0.22, P<0.0001; serum albumin r=0.212, P<0.0001; PNI r=0.287, P<0.0001).

Preoperative mIMAC could be useful for perioperative and postoperative management in CRC and GC.

Preoperative mIMAC could be useful for perioperative and postoperative management in CRC and GC.

A large number of clinical studies have shown that intravenous vitamin C supplementation is beneficial for critically ill patients, but current research conclusions are controversial. This meta-analysis included high-quality randomized controlled trials (RCTs) to evaluate the efficacy of intravenous vitamin C in critically ill patients.

We searched PubMed, EMBASE and the Cochrane Library from inception to August 15, 2020 to identify published reports of RCTs evaluating the role of intravenous vitamin C in critically ill patients. Risk ratios values (RRs) and 95% confidence intervals (CIs) were calculated by random-effects meta-analysis. Trial sequential analysis (TSA), meta-regression, subgroup analyses and sensitivity analyses were also performed.

Our meta-analysis included 18 RCTs involving 2001 patients (1005 with vitamin C treatment and 996 control treatment). Intravenous vitamin C administration reduced the intensive care unit (ICU) length of stay (LOS) (MD=-0.36, 95% CI-0.60 to-0.11, P=0.004) and hospital LOS (MD=-1.50, 95% CI-2.64 to-0.35, P=0.01) but had no significant effect on the longest follow-up mortality, hospital or ICU mortality and change in Sequential Organ Failure Assessment (SOFA) score. TSAs for mortality, ICU and hospital LOS were inconclusive.

Intravenous vitamin C administration may shorten ICU LOS and hospital LOS. It had no effect on mortality and organ failure. All TSAs were inconclusive, and the value of vitamin C for critically ill patients needs to be demonstrated in more high-quality RCTs.

Intravenous vitamin C administration may shorten ICU LOS and hospital LOS. It had no effect on mortality and organ failure. All TSAs were inconclusive, and the value of vitamin C for critically ill patients needs to be demonstrated in more high-quality RCTs.

The association between dietary diversity (DD) changes and mortality remains unclear. We aimed to investigate the association between DD changes and all-cause mortality among older people.

A total of 17,959 participants with a mean age of 84.8 years old were enrolled at baseline. Food groups were collected at baseline and follow-up using simplified food frequency questionnaire (FFQ), and then overall, plant-based and animal-based dietary diversity score (DDS) were calculated. DDS changes were calculated using DDS at baseline and the first follow-up. The association between three DDS changes (overall, plant-based and animal-based DDS) and subsequent all-cause mortality were evaluated. Nonparametrically restricted cubic splines and a multivariable-adjusted Cox proportional hazards model were used to estimate HRs and 95% CIs.

We documented 12,974 deaths over a 129,590 person-years of follow up. Compared with high-to-high DDS pattern, participants with lower overall DDS patterns had increased mortality riske all associated with an increased risk of all-cause mortality.

Regular consumption of fast-food (FF) as a form of typical Western style diet is associated with obesity and the metabolic syndrome, including its hepatic manifestation nonalcoholic fatty liver disease. Currently, it remains unclear how intermittent excess FF consumption may influence liver metabolism. The study aimed to characterize the effects of a single FF binge on hepatic steatosis, inflammation, bile acid (BA), glucose and lipid metabolism.

Twenty-five healthy individuals received a FF meal and were asked to continue eating either for a two-hour period or until fully saturated. Serum levels of transaminases, fasting BA, lipid profile, glucose and cytokine levels as well as transient elastography and controlled attenuation parameter (CAP; to assess hepatic steatosis) were analyzed before (day 0) and the day after FF binge (day 1). Feces was collected prior and after the FF challenge for microbiota analysis.

The FF meal induced a modest increase in CAP, which was accompanied by a robust increase of fasting serum BA levels. Surprisingly, levels of cholesterol and bilirubin were significantly lower after the FF meal. Differentiating individuals with a relevant delta BA (>1μmol/l) increase vs. Selleck MRT68921 individuals without (delta BA≤1μmol/l), identified several gut microbiota, as well as gender to be associated with the BA increase and the observed alterations in liver function, metabolism and inflammation.

A single binge FF meal leads to a robust increase in serum BA levels and alterations in parameters of liver injury and metabolism, indicating a novel metabolic aspect of the gut-liver axis.

A single binge FF meal leads to a robust increase in serum BA levels and alterations in parameters of liver injury and metabolism, indicating a novel metabolic aspect of the gut-liver axis.

Owing to the “obesity-pandemic”, an increasing number of individuals are in need of treatment for obesity and obesity-related disorders. For patients with severe disease, results with conventional treatment modalities such as diet regimens, physical activity, and pharmacologic agents most often lack satisfactory efficacy and/or sustainability. In contrast, bariatric surgery has been demonstrated to be associated with marked, long-term weight loss as well as resolution or improvement of co-morbid disease, in particular metabolic aberrations such as insulin resistance and type 2 diabetes. The underlying mechanisms for the effects of surgery-induced weight loss on such morbidity are incompletely understood.

This article gives an updated overview of some aspects on the mechanisms involved in the improvement in metabolism in obese individuals submitted to surgery-induced weight loss. Patients undergoing Roux en-Y Gastric Bypass (RYGB) were studied before and at various times after the operation. Weight, body composition with determination of distribution of adipose tissue (DEXA), and insulin sensitivity (hyperinsulinemic clamp) was determined.