Purpose: To evaluate incidence and risk factors of peripherally inserted central catheter (PICC)-related complications in cancer patients. Methods: A prospective, multicenter, cohort study of cancer patients with PICC insertion was performed from February 1, 2013 to April 24, 2014. All patients were monitored in clinic until PICCs were removed. The primary endpoint was PICC removal due to complications. Patient-, catheter- and insertion-related factors were analyzed in univariable and multivariable logistic regression analysis to identify significant independent risk factors for PICC-related complications. Results: There were 477 cancer patients included, for a total of 50,841 catheter-days. Eighty-one patients (17.0%) developed PICC-related complications, with an incidence of 1.59 per 1000 catheter days. Thirty-six (7.5%) PICCs were removed because of complications. The most common complications were skin allergy (4.6%), catheter occlusion (3.4%) and accidental withdrawal (2.3%). Nine (1.9%) patients developed symptomatic upper extremity deep venous thrombosis (UEDVT) and central line associated bloodstream infection (CLABSI) was shown in six (1.3%) PICCs with an infection rate 0.12 per 1000 catheter days. In multivariable analysis, body mass index (BMI) >25 (odds ratio, 2.09; 95% confidence interval, 1.26-3.47, p = 0.004) was shown to be a significant risk factor for PICC complications. Conclusions: Cancer patients with BMI greater than 25 were more likely to have PICC complications.

: Intermittent fasting (IF) is a promising paradigm for weight loss which has been shown to modulate the gut microbiota based on 16S rRNA gene amplicon sequencing. Here, 72 Chinese volunteers with a wide range of body mass index (BMI) participated in a three-week IF program during which an average loss of 3.67 kg body weight accompanied with improved clinical parameters was observed irrespective of initial anthropometric and gut microbiota status. Fecal samples were collected before and after the intervention and subjected to shotgun metagenomic sequencing. De novo assembly yielded 2934 metagenome-assembled genomes (MAGs). Profiling revealed significant enrichment of Parabacteroides distasonis and Bacteroides thetaiotaomicron after the intervention, with inverse correlations between their relative abundances and parameters related to obesity and atherosclerotic cardiovascular diseases (ASCVD). MAGs enriched after the intervention showed high richness and diversity of carbohydrate-active enzymes, with an increased relative abundances of genes related to succinate production and glutamate fermentation.

Obesity, a growing global health crisis, is driven by a complex interplay of genetic, biological, environmental, behavioral, socio-cultural, and economic factors. This comprehensive review encapsulates the epidemiology, pathophysiological mechanism, and the myriad of health complications it triggers, such as cardiovascular diseases (CVDs), cancer, neurological disorders, respiratory ailments, digestive diseases, mobility impairments, and psychological stress. The etiology of obesity is multifaceted, involving genetic predispositions, environmental influences, behavioral tendencies, and socio-economic elements. The pathophysiological underpinnings of obesity encompass multifaceted aspects of energy metabolism, including the regulation of appetite, glucose, lipid, and amino acid metabolism. This review also addresses the seemingly contradictory roles of obesity in various diseases, offering insights into these phenomena. The management of obesity is multi-pronged, including lifestyle modifications, pharmacological interventions, and metabolic surgeries. Lifestyle changes are foundational, but advancements in molecular techniques, digital technology, wearable devices, and artificial intelligence are opening new avenues for personalized treatment and early intervention. Pharmacological treatment and metabolic surgery are effective but should be judiciously tailored to individual patient needs. This review underscores the importance of a multifaceted approach to obesity management, aiming to curb the escalating trend and enhance future interventions and treatments. The ultimate goal is to synthesize current evidence and innovative strategies to combat obesity effectively.