Cachexia is a major characteristic of multiple non-malignant diseases, advanced and metastatic cancers and it is highly prevalent in pancreatic cancer, affecting almost 70%–80% of the patients. Cancer cachexia is a multifactorial condition accompanied by compromised appetite and changes in body composition, i.e., loss of fat. It is associated with lower effectiveness of treatment, compromised quality of life, and higher mortality. Understanding the complex pathways underlying the pathophysiology of cancer cachexia, new therapeutic targets will be unraveled. The interplay between tumor and host factors, such as cytokines, holds a central role in cachexia pathophysiology. Cytokines are possibly responsible for anorexia, hypermetabolism, muscle proteolysis, and apoptosis. In particular, cachexia in pancreatic cancer might be the result of the surgical removal of pancreas parts. In recent years, many studies have been carried out to identify an effective treatment algorithm for cachexia. Choosing the most appropriate treatment, the clinical effect and the risk of adverse effects should be taken under consideration. The purpose of this review is to highlight the pathophysiological mechanisms as well as the current ways of cachexia treatment in the pharmaceutical and the nutrition field.

The present cross-sectional prospective study (from January 2017 until December 2020) aimed to evaluate the interrelation between nutritional parameters at the initial evaluation with the changes in QOL indicators and the Progression-Free Survival and Overall Survival in 97 patients with pancreatic cancer. Dietary and nutritional risk assessments, and an evaluation of Frailty and Functional Status were performed. Health-related Quality of Life was evaluated with the EORTC QLQ-C30 questionnaire. Nutritional risk, as evaluated by MNA-SF score, was negatively associated with age (p = 0.003) and positively associated with dynamometry (p = 0.001). In addition, there was a statistically significant difference in the financial difficulties (p = 0.049). OS and PFS were found to decrease in patients who reported having increased fatigue (OS p = 0.007 and PFS p = 0.044). Moreover, higher prevalence of constipation resulted in lower OS and PFS (OS p < 0.001 and PFS p < 0.001) and increased reporting of gastrointestinal problems during the 3 months was connected with lower survival (OS p = 0.017). According to the analysis, our patients were found to have lower OS and PFS, stressing out the necessity to provide early identification and management to symptoms of the disease that could compromise nutritional status. The provision of nutritional advice and guidance is of major importance for patients.

Edible chitosan coating on the surface of ready-to-eat (RTE) bovine meatballs was evaluated for its effect on their shelf life and the control of Listeria monocytogenes at 5 °C. L. monocytogenes was inoculated onto the surface of RTE bovine meatballs with and without edible chitosan coating. The samples were stored at 5 °C. Total aerobic viable count (TVC) and the bacterial counts of L. monocytogenes, lactic acid bacteria and Enterobacteriaceae were determined on days 0,1,7,14,21 and 28. The sensory characteristics were also evaluated at the same time spots by semi trained panelists. The results of the microbiological analysis depicted that the use of edible chitosan membranes reduced all of the microbial populations that were enumerated, and retarded their growth leading to the conclusion that they can prolong the shelf life of these products by 14 days. Moreover, the population of the inoculated L. monocytogenes was about 2 log CFU/g lower in the meatballs coated with chitosan, indicating an inhibitory effect of chitosan in the growth of L. monocytogenes. The sensory analysis showed that the samples coated with chitosan were satisfactorily accepted by the panelists even at day 28, in contrast to the samples without chitosan (control samples) which were unacceptable at day 14. These results indicate that edible chitosan coatings represent a potential agent in controlling L. monocytogenes on the surface of RTE meatballs as well as other RTE meat products, prolonging their shelf life without affecting their sensory characteristics.

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