Objective: To perform a nutritional assessment of the effectiveness of colorectal self-expandable metallic stent (SEMS) placement for patients with obstructive colorectal cancer.

Subjects and methods: Obstructive colorectal cancer patients undergoing management with SEMS between January 2013 and March 2016 were investigated. We compared 16 patients who underwent surgery regaining the ability to ingest food following SEMS placement (Ingestion group) and 18 patients who, while not considered for emergency treatment, underwent nil per os (npo) management while awaiting surgery (NPO group).

Results: Compare to the values before SEMS placement, the Ingestion group showed significantly elevated total lymphocyte account prior surgery. The NPO group showed significantly lower total cholesterol levels. Comparison of the two groups indicated that the preoperative total lymphocyte count in the Ingestion group was significantly higher than that in the NPO group. A significantly high number of patients in the Ingestion group showed improvement in their Controlling Nutritional Status (CONUT) scores. There were no significantly differences in the frequency of postoperative complications or duration of hospital stay.

Conclusions: Although the results suggest that SEMS placement for patients with obstructive colorectal cancer improves preoperative nutritional status, we did not obtain evidence to support active use of SEMS placement in patients with manageable by npo.

Purpose: This study compared the Glasgow Prognostic Score (GPS) with brain natriuretic peptide (BNP) level as prognostic factors in patients with acute decompensated heart failure (ADHF).

Subjects and Methods: We investigated 362 patients with ADHF (75±13 years, 55% male) in this retrospective study. Serum C-reactive protein (CRP), albumin, and BNP concentrations were measured on admission. Patients with both an elevated CRP concentration (>1.0 mg/dL) and hypoalbuminemia (<3.5 g/dL) were assigned a GPS score of 2, those with only one of these abnormalities were assigned a score of 1, and patients with neither were assigned a score of 0. GPS scores of 0, 1, and 2 were observed in 47% (n=170), 30% (n=110), and 23% (n=82) of patients, respectively. The patients were also classified into three groups according to BNP tertiles (T1: 28–462 pg/mL, T2: 474–1,130 pg/mL, T3: 1,131–9,830 pg/mL).

Results: During the median follow-up period of 349 days (interquartile range: 72–825), 67 (18.5%) patients died. Relative to a GPS of 0, the hazard ratios for all-cause death were 4.94 (95% confidence interval 2.26–11.0) for a GPS of 2 and 2.31 (95% confidence interval 1.18–4.61) for a GPS of 1, as determined using adjusted Cox proportional-hazards analysis. In contrast, there were no significant differences among BNP groups.

Conclusions: The GPS is more useful than the BNP level for determination of prognosis in patients with ADHF.

Purpose: In non-diabetic cases, there is a risk of hyperglycemia during total parenteral nutrition (TPN). In this study, we investigated the significance of blood glucose monitoring in non-diabetic patients receiving TPN.

Subjects and Methods: From April 2015 to June 2015, 88 non-diabetic patients received TPN and were measured blood glucose regularly. We investigated the frequency of hyperglycemia over 180 mg/dL, the period from the beginning of TPN to the occurrence of hyperglycemia, patient’s background, infusion calories and the infusion rate of glucose.

Results: Hyperglycemia was observed in 49cases (56%) out of 88 patients. 70% of the hyperglycemia cases occurred within 1 week. Some patients had hyperglycemia over 4weeks from the beginning of TPN. There were no cases in which infusion rate of glucose exceeded 5 mg/kg/min. There were only two cases in which it seemed to be overfeeding. In cases of hyperglycemia group, there were a lot of antibacterial medicine use cases and fasting cases statistically. There were no significant differences between hyperglycemia and euglycemia cases on the levels of the age, BMI, infusion rate of glucose, infusion calories,presence of an operation and usage of glucocorticoid.

Conclusions: In non-diabetic cases, there is a risk of hyperglycemia during TPN even under appropriate nutritional management. It's necessary for risk management to mesure periodic blood glucose.