Purpose: This study evaluated the postoperative quality of life (QoL) after various types of gastrectomy for gastric cancer. Materials and Methods: A multicenter prospective observational study was conducted in Korea using the Korean Quality of Life in Stomach Cancer Patients Study (KOQUSS)-40, a new QoL assessment tool focusing on postgastrectomy syndrome. Overall, 496 patients with gastric cancer were enrolled, and QoL was assessed at 5 time points: preoperatively and at 1, 3, 6, and 12 months after surgery. Results: Distal gastrectomy (DG) and pylorus-preserving gastrectomy (PPG) showed significantly better outcomes than total gastrectomy (TG) and proximal gastrectomy (PG) with regard to total score, indigestion, and dysphagia. DG, PPG, and TG also showed significantly better outcomes than PG in terms of dumping syndrome and worry about cancer. Postoperative QoL did not differ significantly according to anastomosis type in DG, except for Billroth I anastomosis, which achieved better bowel habit change scores than the others. No domains differed significantly when comparing double tract reconstruction and esophagogastrostomy after PG. The total QoL score correlated significantly with postoperative body weight loss (more than 10%) and extent of resection (P<0.05 for both).Reflux as assessed by KOQUSS-40 did not correlate significantly with reflux observed on gastroscopy 1 year postoperatively (P=0.064). Conclusions Our prospective observation using KOQUSS-40 revealed that DG and PPG lead to better QoL than TG and PG. Further study is needed to compare postoperative QoL according to anastomosis type in DG and PG.

Objectives: Excessive sedentary behavior in youth is a major global issue, contributing to the rise in childhood obesity and metabolic diseases. International public health authorities have issued guidelines recommending that children and adolescents limit their daily sedentary time, including screen time. However, to date, no studies have explored the relationship between sedentary behavior as an exposure factor and skeletal muscle strength and mass as outcomes in this population. The present study investigated the association of sedentary behavior with handgrip strength (HGS) and appendicular lean mass (ALM) among United States adolescents. Methods: A total of 1449 adolescent participants from the National Health and Nutrition Examination Survey (2011-2014) were included. Information on sedentary behavior, specifically daily sedentary time, was obtained through a self-reported questionnaire. Muscular parameters, including HGS and ALM, were measured. To adjust for differences in body size, these parameters were divided by body mass index (BMI) and weight. Linear regression analyses were performed to evaluate the associations between daily sedentary time and each muscular parameter, adjusting for age, sex, ethnicity, annual family income, and moderate-to-vigorous physical activity (MVPA). Results: The linear regression analyses revealed negative associations between daily sedentary time and all muscular parameters, apart from absolute ALM. These included HGS (β, -0.265; standard error [SE], 0.074; p=0.001), HGS/BMI (β, -0.021; SE, 0.004; p<0.001), HGS/weight (β, -0.008; SE, 0.002; p<0.001), ALM/BMI (β, -0.008; SE, 0.003; p=0.010), and ALM/weight (β, -0.003; SE, 0.001; p=0.005). Conclusions After adjusting for MVPA, daily sedentary time was inversely associated with HGS, HGS/BMI, HGS/weight, ALM/BMI, and ALM/weight in United States adolescents.

Frailty is a condition marked by a progressive decline in physiological functioning due to aging, leading to increased disease morbidity and rising healthcare costs. Therefore, it is important to prevent frailty through proper management. Not only does a lack of physical activity contribute to frailty, but inadequate dietary intake, resulting from decreased appetite and malabsorption, is also a significant risk factor. This study aimed to develop a 16-week algorithm to assess the nutritional risks associated with frailty, provide personalized nutritional solutions, and manage frailty risk factors through continuous monitoring and periodic reassessment. A total of 20 indicators were selected to create a nutritional health score. The selected indicators encompassed nutritional risk factors for frailty, disease history, and hematological factors. Reassessments were designed to occur at four-week intervals to revise personalized management goals and adjust solutions. Metrics were prioritized to provide a personalized solution. A user-friendly monitoring system was developed that leveraged voice recognition technology to determine compliance. It is anticipated that the algorithm will serve several purposes. First, this outcome will allow us to help prevent and delay the onset of frailty by utilizing a mobile app. Second, it will reduce the time and economic costs associated with nutritional management. Finally, it will facilitate future professional counseling and monitoring.

Orthopedic surgery is becoming increasingly common, particularly among older adults, due to population aging and the rising incidence of degenerative conditions. Older patients frequently have multiple comorbidities, which elevate the risk of surgical complications. Effective pain management is crucial in facilitating recovery and reducing the likelihood of postoperative complications. This review examines the role of regional anesthesia in optimizing recovery outcomes for orthopedic patients.Current Concepts: Regional anesthesia significantly reduces opioid consumption, which in turn mitigates side effects such as nausea, vomiting, respiratory depression, and urinary retention. It also promotes early mobilization, which is crucial for functional recovery, and helps prevent complications such as deep vein thrombosis and muscle atrophy. Advanced techniques like local infiltration analgesia and motor-sparing blocks offer effective pain relief while preserving muscle strength. This not only facilitates faster rehabilitation but also reduces the length of hospital stays. These advantages underscore the importance of regional anesthesia in improving surgical outcomes and expediting recovery.Discussion and Conclusion: Regional anesthesia is crucial in improving recovery after orthopedic surgery by providing effective pain management, facilitating early mobilization, and minimizing complications. It is essential to customize the anesthetic approach based on the specific surgical procedure and the patient’s overall health to achieve optimal outcomes.

Objectives: Excessive sedentary behavior in youth is a major global issue, contributing to the rise in childhood obesity and metabolic diseases. International public health authorities have issued guidelines recommending that children and adolescents limit their daily sedentary time, including screen time. However, to date, no studies have explored the relationship between sedentary behavior as an exposure factor and skeletal muscle strength and mass as outcomes in this population. The present study investigated the association of sedentary behavior with handgrip strength (HGS) and appendicular lean mass (ALM) among United States adolescents. Methods: A total of 1449 adolescent participants from the National Health and Nutrition Examination Survey (2011-2014) were included. Information on sedentary behavior, specifically daily sedentary time, was obtained through a self-reported questionnaire. Muscular parameters, including HGS and ALM, were measured. To adjust for differences in body size, these parameters were divided by body mass index (BMI) and weight. Linear regression analyses were performed to evaluate the associations between daily sedentary time and each muscular parameter, adjusting for age, sex, ethnicity, annual family income, and moderate-to-vigorous physical activity (MVPA). Results: The linear regression analyses revealed negative associations between daily sedentary time and all muscular parameters, apart from absolute ALM. These included HGS (β, -0.265; standard error [SE], 0.074; p=0.001), HGS/BMI (β, -0.021; SE, 0.004; p<0.001), HGS/weight (β, -0.008; SE, 0.002; p<0.001), ALM/BMI (β, -0.008; SE, 0.003; p=0.010), and ALM/weight (β, -0.003; SE, 0.001; p=0.005). Conclusions After adjusting for MVPA, daily sedentary time was inversely associated with HGS, HGS/BMI, HGS/weight, ALM/BMI, and ALM/weight in United States adolescents.

Frailty is a condition marked by a progressive decline in physiological functioning due to aging, leading to increased disease morbidity and rising healthcare costs. Therefore, it is important to prevent frailty through proper management. Not only does a lack of physical activity contribute to frailty, but inadequate dietary intake, resulting from decreased appetite and malabsorption, is also a significant risk factor. This study aimed to develop a 16-week algorithm to assess the nutritional risks associated with frailty, provide personalized nutritional solutions, and manage frailty risk factors through continuous monitoring and periodic reassessment. A total of 20 indicators were selected to create a nutritional health score. The selected indicators encompassed nutritional risk factors for frailty, disease history, and hematological factors. Reassessments were designed to occur at four-week intervals to revise personalized management goals and adjust solutions. Metrics were prioritized to provide a personalized solution. A user-friendly monitoring system was developed that leveraged voice recognition technology to determine compliance. It is anticipated that the algorithm will serve several purposes. First, this outcome will allow us to help prevent and delay the onset of frailty by utilizing a mobile app. Second, it will reduce the time and economic costs associated with nutritional management. Finally, it will facilitate future professional counseling and monitoring.

Orthopedic surgery is becoming increasingly common, particularly among older adults, due to population aging and the rising incidence of degenerative conditions. Older patients frequently have multiple comorbidities, which elevate the risk of surgical complications. Effective pain management is crucial in facilitating recovery and reducing the likelihood of postoperative complications. This review examines the role of regional anesthesia in optimizing recovery outcomes for orthopedic patients.Current Concepts: Regional anesthesia significantly reduces opioid consumption, which in turn mitigates side effects such as nausea, vomiting, respiratory depression, and urinary retention. It also promotes early mobilization, which is crucial for functional recovery, and helps prevent complications such as deep vein thrombosis and muscle atrophy. Advanced techniques like local infiltration analgesia and motor-sparing blocks offer effective pain relief while preserving muscle strength. This not only facilitates faster rehabilitation but also reduces the length of hospital stays. These advantages underscore the importance of regional anesthesia in improving surgical outcomes and expediting recovery.Discussion and Conclusion: Regional anesthesia is crucial in improving recovery after orthopedic surgery by providing effective pain management, facilitating early mobilization, and minimizing complications. It is essential to customize the anesthetic approach based on the specific surgical procedure and the patient’s overall health to achieve optimal outcomes.