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Background: Glioblastoma (GBM) is the most common malignant brain tumor in adults and still carries a dismal prognosis. As several studies detected a connection between inflammation and GBM prognosis, we sought to explore possible associations between routinely investigated inflammatory parameters and GBM outcome. Patients and Methods: Patients treated for GBM at our Institution between 2004 and 2014 were included. White blood cell count (WBC), C-reactive protein (CRP) and the ratio of platelets and WBC (Plt/WBC) were evaluated preoperatively. Medical records were reviewed for clinical parameters (age, sex, preoperative clinical condition, genetic alterations). Study endpoints were overall (OS) and 1-and 2-year survival. Results: In the final cohort consisting of 565 individuals with GBM, univariate analysis showed significant associations for WBC, CRP and Plt/WBC ratio with OS. Kaplan-Meier survival plot confirmed significantly poorer OS in patients with WBC>12/nl and with CRP≥2.9 mg/dl. In multivariate analysis, a WBC of >12/nl was an independent prognostic factor for all three outcome parameters and CRP≥2.9 mg/dl for OS and 1-year survival. Conclusion: Preoperative WBC and CRP values were confirmed as independent predictors of GBM outcome. This emphasizes the need for further evaluation of the role of inflammation in the prognosis of GBM.

Objective To assess the feasibility of a prehabilitation program and its effects on physical performance and outcomes after major abdominal surgery. Methods In this prospective pilot study, patients underwent prehabilitation involving three training sessions per week for 3 weeks preoperatively. The feasibility of delivering the intervention was assessed based on recruitment and adherence to the program. Its impacts on fitness (oxygen uptake (VO2)) and physical performance (Timed Up and Go Test, 6-Minute Walk Test) were evaluated. Results From May 2017 to January 2020, 980 patients were identified and 44 (4.5%) were invited to participate. The main obstacles to patient recruitment were insufficient time (<3 weeks) prior to scheduled surgery (n = 276, 28%) and screening failure (n = 312, 32%). Of the 44 patients, 24 (55%) declined to participate, and 20 (23%) were included. Of these, six (30%) were not adherent to the program. Among the remaining 14 patients, VO2 at ventilatory threshold significantly increased from 9.7 to 10.9 mL/min/kg. No significant difference in physical performance was observed before and after prehabilitation. Conclusion Although prehabilitation seemed to have positive effects on exercise capacity, logistic and patient-related difficulties were encountered. The program is not feasible in its current form for all-comers.

In rats 70% of the small bowel was resected with preservation of duodenum and terminal ileum. Two and four weeks later transport of sodium, chloride, water, and galactose was studied in duodenum and ileum. Controls were sham-operated and unoperated rats. There was significant mucosal growth 2 and 4 wk after resection. By 2 wk postresection transport specific activities (transport per gram mucosa) were generally decreased. Mucosal growth compensated only sufficiently so that transport capacities (transport per centimeter segment length) remained unaltered from controls. By 4 wk postresection transport specific activities had either increased or were unchanged from controls. Therefore, in association with mucosal growth, transport capacities increased. The major adaptive increases for electrolytes and water occurred in duodenum; ileum was the site of increased galactose transport. The data indicate that 1) mucosal growth and functional transport changes occur as separate adaptive phenomena and 2) adaptive transport mechanisms are selectively localized to particular regions of the intestine.

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