Purpose: Palliative resection and palliative stenting are established options for managing obstruction in patients with metastatic left-sided colonic cancer. This retrospective study investigated the long-term outcomes and survival associated with each treatment modality. Methods: Patients with left-sided colon cancer complicated by intestinal obstruction and unresectable metastatic lesions were included. Propensity score matching was conducted to balance demographic characteristics. The primary outcome was long-term survival. Secondary outcomes included short-term morbidity, length of hospital stay, clinical success rate, stoma formation rate, and number of readmissions due to tumor-related complications. Results: Initially, 131 patients who underwent palliative resection or stenting between 2015 and 2022 were included. After propensity score matching, 98 patients remained (49 in each group). Survival was significantly better among patients receiving palliative resection compared to stenting (median, 19.6 months vs. 9.6 months; P=0.003). However, subgroup analysis for patients older than 70 years demonstrated no statistically significant survival benefit (median, 11.5 months vs. 10.2 months; P=0.240). The resection group experienced significantly higher rates of stoma formation and longer postoperative hospital stays. Readmission rates were similar. Cox regression analysis identified low carcinoembryonic antigen levels, tumor resection, chemotherapy, and targeted therapy as independent predictors of longer survival. Conclusion For metastatic colon cancer patients presenting with intestinal obstruction, palliative resection may offer a survival advantage. However, this benefit diminishes in patients over 70 years of age. Additionally, resection is associated with a higher rate of stoma formation. Therefore, individualized treatment decisions are warranted when choosing between palliative resection and palliative stenting in metastatic colonic cancer patients.

INTRODUCTIONThe aim of this paper is to review the cardiovascular (CVS) risks associated with obesity in children and adolescents. Both short-term and long-term CVS consequences, the mechanisms of how these develop and the measures that can alter or reverse these CVS events are reviewed.

MATERIALS AND METHODSSelected publications include original articles and review papers that report on studies of CVS risks and consequences related to childhood obesity. Some papers that contain data from adults studies are also included if the contents help to explain some underlying mechanisms or illustrate the continuation of related CVS changes into adulthood.

RESULTSObese children and adolescents have an increased risk for CVS complications that include elevation of blood pressure, clustering of CVS risk factors (Metabolic Syndrome), changes to arterial wall thickness, elasticity and endothelium, as well as changes in left ventricular structure and function. Some of these cardiovascular problems may be initiated or potentiated by obstructive sleep apnoea that can accompany obesity in children. Many of such changes have been noted to reverse or improve with weight reduction.

CONCLUSIONSEarly development of CVS risks in obese children and the possible continuation of CVS complications into adulthood have been observed. Obstructive sleep apnoea in obese children can further contribute to such CVS risks. These findings underscore the importance of prevention of childhood obesity as a priority over management of obesity in children.

Adolescent ; Cardiovascular Diseases ; etiology ; Child ; Humans ; Obesity ; complications ; Risk Factors

INTRODUCTIONThis study investigated the responses of plasma endotoxin and pro- and antiinflammatory cytokines during a 21-km road race in warm and humid conditions. The influence of carbohydrate-electrolyte (CE)-water (WA) drink mix ingested on leukocyte subset responses and the association between plasma lipopolysaccharide (LPS) concentration and fluid balance, exercise intensity, and body core temperature (Tc) were also studied.

MATERIALS AND METHODSThirty runners provided blood samples before and after the half-marathon for leukocyte, LPS and cytokine analyses. Tc was measured by the ingestible telemetric temperature sensor and fluid intake and split-times were recorded at 3 km intervals. Exercise intensity was determined by matching running speed and heart rate during the race with the corresponding speed-oxygen uptake relationship and heart rate measured in the laboratory 2 to 6 weeks before the race.

RESULTSPlasma LPS concentration increased from 1.9 +/- 1.9 pg/mL before, to 2.5 +/- 1.9 pg/mL after running (P <0.05). Peak plasma LPS concentration was 7.5 pg/mL. Plasma IL-1beta and TNF-concentration did not change significantly, whereas significant increases in IL-10 (50%), IL-1ra (23.2%) and IL-6 (65.2%) were observed after the race. No significant correlation between plasma LPS concentration and exercise intensity, hydration and Tc was observed.

CONCLUSIONLeukocyte subset responses were not related to the ratio of CE and water drink mix ingested. Running a half-marathon can induce mild endotoxaemia, which is not related to exercise intensity, fluid balance, and Tc responses. Mixing CE drink with water did not mitigate postexercise leukocytosis and lymphopenia.

Adult ; Beverages ; Cytokines ; immunology ; Endotoxins ; blood ; immunology ; Fluid Therapy ; Hot Temperature ; Humans ; Humidity ; Leukocytes ; immunology ; Lipopolysaccharides ; immunology ; Male ; Physical Exertion ; physiology ; Running ; physiology