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Although several studies have reported an association between malnutrition and the risk of severe complications after abdominal surgery, there have been no studies evaluating the use of Global Leadership Initiative on Malnutrition (GLIM) criteria for predicting postoperative pulmonary complications (PPCs) following major abdominal surgery in cancer patients. This study aimed to investigate the association among the diagnosis of malnutrition by GLIM criteria, PPCs risk and 90-day all-cause mortality rate following major abdominal surgery in cancer patients. We prospectively analyzed 218 patients (45% male, mean age 70.6 ± 11.2 years) with gastrointestinal cancer who underwent major abdominal surgery at our hospital between October 2018 and December 2019. Patients were assessed preoperatively using GLIM criteria of malnutrition, and 90-day all-cause mortality and PPCs were recorded. In total, 70 patients (32.1%) were identified as malnourished according to GLIM criteria, of whom 41.1% fulfilled the criteria for moderate and 12.6% for severe malnutrition. PPCs were detected in 48 of 218 patients (22%) who underwent major abdominal surgery. Univariate logistic regression analysis revealed that the diagnosis of malnutrition was significantly associated with the risk of PPCs. Furthermore, in multivariate model analysis adjusted for other clinical confounding factors, malnutrition remained an independent factor associated with the risk of PPCs (RR = 1.82; CI = 1.21–2.73) and 90-day all-cause mortality (RR = 1.97; CI = 1.28–2.63, for severely malnourished patients). In conclusion, preoperative presence of malnutrition, diagnosed by the use of GLIM criteria, is associated with the risk of PPCs and 90-day mortality rate in cancer patients undergoing major abdominal surgery.

Current pharmacotherapy for acute lung injury (ALI) and the acute respiratory distress syndrome (ARDS) is not optimal, while the biological and physiological complexity of these severe lung injury syndromes requires consideration of combined-agent treatments or agents with pleiotropic action. In this regard, exogenous erythropoietin (EPO) represents a possible candidate since a number of preclinical studies have revealed beneficial effects of EPO administration in various experimental models of ALI. Taken together, this treatment strategy is not a single mediator approach, but it rather provides protection by modulating multiple levels of early signaling pathways involved in apoptosis, inflammation and peroxidation, potentially restoring overall homeostasis. Furthermore, EPO appears to confer vascular protection by promoting angiogenesis. However, only preliminary studies exist and more experimental and clinical studies are necessary for the clarification of the efficacy and potentially cytoprotective mechanisms of EPO action. In addition to the attempts to optimize the dose and timing of EPO administration, it would be of great value to minimize any potential toxicity, which is essential for EPO to fulfil its role as a potential candidate for the treatment of ALI in routine clinical practice. The present article reviews recent advances that have elucidated biological and biochemical activities of EPO which may be potentially applicable for ALI/ARDS management.

Extensive chemotaxonomic investigations of the large genus Centaurea have been carried out (1, 2). Characteristic constituents of Centaurea species (Asteraceae), many of which are used in folk medicine, are by order of their abundance, guaianolides, germacranolides, eudesmanolides and elemanolides. Many of them exhibited various biological activities, e.g., cytotoxicity, neurotoxicity, phytotoxicity, etc. (3-6). Our study of this genus involved the aerial parts of two endemic Greek species. Both taxa, belonging to the section Acrolophus (Cass.) DC., were collected during flowering season (june, 1997): C. thessala Hausskn. subsp. drakiensis (Freyn & Sint.) Georg (Mount Pelioncentral Greek mainland) and C attica Nym. subsp. attica (Mount Parnes-Attiki) (7). Voucher specimens of the investigated taxa are deposited in the Herbarium of Patras University (UPA) under the numbers Skaltsa & Lazari 105 (C. thessala subsp. drakiensis) and Skaltsa & Lazari 106 (C attica subsp. attica).

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