稲熊 岳

<jats:sec><jats:title>Aim</jats:title><jats:p>Malnutrition is reportedly associated with the development of delirium. As dental health is essential for nutritional intake, tooth loss may be a risk factor for the development of delirium. This study aimed to investigate the relationship between postoperative delirium and the number of remaining teeth in patients undergoing gastrointestinal surgery.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>This retrospective study included 453 consecutive patients aged ≥65 years who underwent programmed gastrointestinal cancer surgery under general anesthesia at the Department of Surgery, Fujita Health University Hospital, between January 2022 and December 2022. Background factors were prepared between the participants with and without dental intervention. In the dental intervention group, associations between background and surgical factors and the presence of postoperative delirium were explored. Factors with significant associations with postoperative delirium in the univariate analysis were subjected to logistic regression analysis to determine their association with the number of remaining teeth.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Overall, 189 participants underwent postoperative management. They had a significantly lower Prognostic Nutritional Index and higher cognitive decline than the 264 patients who underwent no dental intervention during this period. However, no significant difference was observed in the incidence of postoperative delirium between the two groups. In the dental intervention group, logistic regression analyses revealed that postoperative complications and the number of remaining teeth were significantly associated with postoperative delirium development.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The results revealed that a decrease in the number of remaining teeth is associated with postoperative delirium. The cause of this is not clear, but it is thought to be related to brain fragility. <jats:bold>Geriatr Gerontol Int 2024; ••: ••–••</jats:bold>.</jats:p></jats:sec>

The current study aimed to investigate the relationship between muscle mass proportion and the incidence of total complications in male gastric cancer (GC) patients after minimally invasive distal gastrectomy (MIDG). Between March 2017 and March 2020, 152 male GC patients with clinical stage III or lower GC who underwent MIDG were enrolled in this study. The muscle mass ratio (MMR) was calculated by dividing the total muscle weight obtained from bioelectrical impedance analysis by the whole-body weight. Thereafter, the association between MMR and surgical outcomes was determined. Based on the optimal MMR cutoff value of 0.712 obtained using the receiver operating characteristic (ROC) curve, patients were divided into two groups (69 and 83 patients in the MMR-L and MMR-H groups). The MMR-L group had a significantly higher total complication rate compared to the MMR-H group (MMR-L, 24.6% vs. MMR-H, 7.2%; P = 0.005). Multivariate analysis also identified MMR-L as a significant independent risk factor for total complications and intra-abdominal infectious complications after MIDG. The MMR calculated using bioelectrical impedance analysis can be a useful predictor for postoperative complications after MIDG in male GC patients.

<h4>Background</h4>Dermatomyositis is associated with malignant tumors including breast cancer, and inflammatory breast cancer is considered to have a poorer prognosis than most breast cancers.<h4>Case presentation</h4>A 74-year-old Asian woman, developed erythema on her face, back, and the back of her hands, 3 weeks before attending our department. At the same time, she had noticed a right breast mass and redness of the skin of the breast. The clinical findings and vacuum aspiration biopsy diagnosed inflammatory breast cancer and neoadjuvant chemotherapy was performed. The mass and enlarged axillary lymph nodes had shrunk, therefore a total mastectomy was performed. The sentinel lymph node biopsy was negative. She was discharged 7 days after surgery without any complications. She has received a postoperative aromatase inhibitor and is alive without recurrence. The dermatomyositis also began to improve with the start of her chemotherapy and has not recurred since the surgery.<h4>Conclusions</h4>Neoadjuvant chemotherapy was performed for inflammatory breast cancer with dermatomyositis, and tumor shrinkage was confirmed. A total mastectomy without axillary lymph node dissection was performed. Dermatomyositis and breast cancer have not recurred. Dermatomyositis may have been a paraneoplastic syndrome due to breast cancer.