Sarcopenia, which is characterized by progressive and generalized loss of skeletal muscle mass and strength, has been well described to be associated with numerous poor postoperative outcomes, such as increased perioperative mortality, postoperative sepsis, prolonged length of stay, increased cost of care, decreased functional outcome, and poorer oncological outcomes in cancer surgery. Multimodal prehabilitation, as a concept that involves boosting and optimizing the preoperative condition of a patient prior to the upcoming stressors of a surgical procedure, has the purported benefits of reversing the effects of sarcopenia, shortening hospitalization, improving the rate of return to bowel activity, reducing the costs of hospitalization, and improving quality of life. This review aims to present the current literature surrounding the concept of sarcopenia, its implications pertaining to colorectal cancer and surgery, a summary of studied multimodal prehabilitation interventions, and potential future advances in the management of sarcopenia.

Cardiac Catheterization ; instrumentation ; methods ; Cardiac Output ; Confidence Intervals ; Female ; Hemodynamics ; Humans ; Middle Aged ; Mitral Valve Stenosis ; pathology ; Pulmonary Artery ; physiology ; Statistics as Topic

The purpose of this study was to evaluate predictors of change in physical function in individuals diagnosed with chronic fatigue syndrome (CFS) following participation in nurse delivered, non-pharmacologic interventions. Participants diagnosed with CFS were randomly assigned to one of four, 6-month interventions including cognitive behavior therapy, cognitive therapy, anaerobic exercise, or a relaxation control group. Baseline measures including immune function, actigraphy, time logs, sleep status, and past psychiatric diagnosis significantly differentiated those participants who demonstrated positive change over time from those who did not. Understanding how patient subgroups differentially respond to non-pharmacologic interventions might provide insights into the pathophysiology of this illness.

Endemic malaria still exists in the Republic of Vanuatu, an 80-island archipelago that sits astride the southeast margin of the Southeast Asian-Melanesian malaria band (Buxton Line 170 degrees E, 20 degrees S). The annual parasite incidence has decreased dramatically over the past decade, which has been attributed to an intensive insecticide-treated bednet distribution program and implementation of a revised Plasmodium falciparum treatment policy that employs combination chloroquine + sulfadoxinelpyrimethamine as a first-line therapy. Standard malariometric surveys were conducted at 10 locations in 2 provinces, screening 2351 adults and children towards the end of the peak transmission season. Spleen rates were consistent with mesoendemic malaria. Examination of blood slides revealed a mean slide-positive rate of 22% (range 4% to 33%). P. falciparum predominated, accounting for 73% of infections, followed by P. vivax (25%). Among 396 individuals with P. falciparum, the gametocyte rate was 54%, with 37% presenting gametocytes alone without asexual stages. Only 8% and 4% of persons with asexual stage P. falciparum and P. vivax parasitaemia, respectively, were symptomatic. These data suggest that malaria transmission has increased in some locations in Vanuatu over the past decade and this report underscores the importance of appropriate bednet use and vector control in this setting as well as the impact of adding sulfadoxine/pyrimethamine and removing primaquine from the national malaria treatment formulary.
Malaria ; upper case pea ; Vanuatu ; control ; asexual