Cancer-related anorexia/cachexia is known to be associated with worsened quality of life and survival; however, limited treatment options exist. Although megestrol acetate (MA) is often used off-label to stimulate appetite and improve anorexia/cachexia in patients with advanced cancers, the benefits are controversial. The present meta-analysis aimed to better elucidate the clinical benefits of MA in patients with cancer-related anorexia/cachexia. A systematic search of PubMed, EMBASE, OVID Medline, Clinicaltrials.gov, and Google Scholar databases found 23 clinical trials examining the use of MA in cancer-related anorexia. The available randomized, controlled trials were appraised using Version 2 of the Cochrane risk-of-bias tool (RoB 2) and they had moderate-to-high risk of bias. A total of eight studies provided sufficient data on weight change for meta-analysis. The studies were divided into high-dose treatment (>320 mg/day) and low-dose treatment (≤320 mg/day). The overall pooled mean change in weight among cancer patients treated with MA, regardless of dosage was 0.75 kg (95% CI = −1.64 to 3.15, τ² = 9.35, I² = 96%). Patients who received high-dose MA tended to have weight loss rather than weight gain. There were insufficient studies to perform a meta-analysis for the change in tricep skinfold, midarm circumference, or quality of life measures. MA was generally well-tolerated, except for a clear thromboembolic risk, especially with higher doses. On balance, MA did not appear to be effective in providing the symptomatic improvement of anorexia/cachexia in patients with advanced cancer.

An increasing number of patients are diagnosed with exertional rhabdomyolysis secondary to indoor spinning. We performed a systematic review to characterize the clinical features of this new clinic...

Concanavalin A (Con A) suppresses auxin-induced elongation of surface-abraded segments from both dicotyledonous and poaceous plants. In coleoptile segments of rice (Oryza sativa L.), the auxin-induced decrease in the minimum stress-relaxation time and increase in the mechanical extensibility of the cell walls were also inhibited by Con A, indicating that the lectin suppresses elongation by inhibiting the cell wall loosening. Auxin caused a decrease in the level of (1 → 3), (1 → 4)-β-D-glucans in the cell walls of rice coleoptile segments, and this decrease was also inhibited by the lectin. Con A suppressed the autolytic hydrolysis of the glucans, as well as their breakdown in vitro by a protein fraction that had been extracted from the cell walls of rice coleoptiles with 1 M NaCl. Furthermore, most of the glucan-hydrolyzing activity of the wall proteins bound to a Con A-Sepharose column, suggesting that glycoprotein enzymes are involved in the hydrolysis. Although Con A also affected the hydrolysis of other wall polysaccharides, the present data, when considered in combination with the inhibitory effects of glucan-specific or glucanasespecific antibodies, support the view that the breakdown of (1 → 3),(1 → 4)-β-D-glucans is associated with the cell wall loosening that is responsible for auxin-induced elongation in Poaceae.