Objective: To compare the effects of eccentric cycling (ECC), concentric cycling (CON), and standard care (CTL) on cardiopulmonary capacity, respiratory health, and quality of life (QoL) in patients with chronic kidney disease (CKD). Methods: Thirty-one CKD patients were divided into the CTL, CON, and ECC groups. The CON and ECC groups participated in 8-week, 24-session cycling programs. Outcomes were assessed through cardiopulmonary exercise tests, respiratory function tests, and the 36-Item Short Form Survey Instrument questionnaire. Results: The ECC group achieved significant improvements in maximal oxygen uptake, while the CTL group showed a decline. For oxygen uptake efficiency slope, significant changes were observed only in the ECC group, with a group-by-time interaction effect compared to CTL. Furthermore, the ECC group demonstrated the most significant increase in diaphragm movement and a significant increase in diaphragm thickness, with comparisons indicating that ECC outperformed both CTL and CON. Regarding QoL, the ECC group exhibited significantly greater improvements in Physical Component Summary and Mental Component Summary, with statistically significant differences compared with the CTL and CON groups. Conclusion ECC is a low-effort, high-benefit exercise modality that significantly enhances cardiopulmonary fitness, respiratory function, and QoL in patients with CKD.

Background: Chemoradiotherapy is the standard treatment for esophageal cancer, but the optimal radiation dose remains undetermined. A dose of 50.4 Gy is commonly used in both neoadjuvant and definitive settings. This study evaluates the outcomes of using 50.4 Gy in neoadjuvant chemoradiotherapy (nCRT). Methods: Patients with esophageal cancer who underwent nCRT with 50.4 Gy radiation followed by surgery between 2010 and 2023 were retrospectively analyzed. They were categorized as achieving pathological complete response (pCR patients) or not (non-pCR patients). Oncological outcomes, including overall survival (OS) and recurrence-free survival (RFS), were assessed. Results: Among 258 patients treated with nCRT, 96.5% completed the treatment protocol, and 74.4% (n=192) proceeded to surgery. These 192 patients formed the analysis cohort. The overall complication rate was 70.3%, with 19.3% classified as major complications. The 30-day and 90-day postoperative mortality rates were both 0.5%. The pCR rate was 45%. Patients with pCR had a 3-year OS rate of 72.7% and a median survival of 125 months, whereas non-pCR patients had a 3-year OS rate of 49.6% and a median survival of 35 months (p=0.002). Additionally, pCR patients had a 3-year RFS rate of 62.0% and a median RFS of 68 months, compared to 33.6% and 20 months, respectively, for non-pCR patients (p<0.001). Conclusion This study reports the outcomes of using 50.4 Gy in nCRT for locally advanced esophageal cancer. The findings affirm the efficacy of 50.4 Gy neoadjuvant chemoradiotherapy in achieving favorable long-term outcomes, particularly among patients with complete pathological response.

Background: The coronavirus disease 2019 (COVID-19) pandemic disrupted healthcare and worsened quality of life (QOL). Advanced esophageal cancer is often accompanied by malnutrition and poor QOL; chemoradiotherapy (CRT) remains the mainstay of treatment.We evaluated nutrition and QOL pre- and post-CRT immediately before and during the pandemic. Methods: Patients with esophageal cancer who underwent neoadjuvant or definitive CRT between April 2019 and December 2020 were enrolled. Disease severity, treatment timing, and outcomes were compared for cohorts treated pre-COVID-19 and during COVID-19. Nutritional status was measured with the Patient-Generated Subjective Global Assessment (PG-SGA). QOL was measured with the Mandarin Chinese version of the European Organization for Research and Treatment of Cancer core questionnaire (EORTC QLQ-C30) and the esophageal site-specific module (QLQ-OES18). In the pandemic cohort, pre-/post-CRT paired analyses were performed. Results: Eighty-four patients were enrolled. The median diagnosis to treatment interval lengthened during COVID-19 (17.8 days vs. 24.2 days, p=0.04). Among the patients treated during the COVID-19 pandemic, nutritional status improved significantly following CRT (p=0.003). In the EORTC QLQ-C30, post-CRT scores for global health status (p<0.01) and emotional functioning (p<0.01) showed significant improvement. Additionally, symptom scores, including fatigue (p=0.02) and nausea and vomiting (p=0.02), decreased. However, financial difficulties worsened after CRT (p=0.02). In the EORTC QLQ-OES18, post-CRT symptom scores for eating (p<0.01), reflux (p=0.03), and pain (p<0.01) showed significant improvement. Conclusion Despite COVID-19-related delays, CRT enhanced nutrition, global health, and symptom control in esophageal cancer, although financial burdens increased. Integrating socioeconomic support with oncologic care is vital during health crises.

Epidermis ; pathology ; Humans ; Male ; Middle Aged ; Necrosis ; diagnosis ; Skin Diseases ; diagnosis