Malnutrition develops in 79% patients with esophageal cancer. Thus, these patients represent a group of cancer patients, which is the most nutritionally compromised. Dysphagia and more than 10% loss of body weight are already present at the time of diagnosis. Treatments for esophageal cancer contribute significantly to the development of malnutrition. This paper describes the nutritional treatment of patients and nutritional strategies in patients with dysphagia and other nutritional problems that accompany the treatment of patients with esophageal cancer. Here are shown the types and methods of nutritional support, which are suitable for this group of patients. Nutritional support of patients with esophageal cancer is performed as a parallel therapeutic route.

BackgroundEsophageal cancer remains a disease with poor survival and many complications. Measuring muscle mass and quality can identify patients with diminished muscle mass (sarcopenia) and muscle fat infiltration (myosteatosis). We studied the impact of sarcopenia and myosteatosis in resectable esophageal cancer on overall survival and complications.Patients and methods139 patients received a radical esophagectomy. Skeletal muscle area (SMA) and muscle attenuation (MA) in CT images at L3 level were recorded and groups with and without sarcopenia and myosteatosis were compared for overall survival (OS), perioperative mortality, conduit complications, pleuropulmonary complications, respiratory failure requiring mechanical ventilation and other significant complications.ResultsPrevalence of sarcopenia and myosteatosis at presentation was 16.5% and 51.8%, respectively. Both were associated with decreased OS. Median survival was 18.3 months (CI 5.4–31.1) vs 31.0 months (CI 7.4–54.6) for sarcopenia/no sarcopenia (log rank p = 0.042) and 19.0 months (CI 13.3–24.7) vs 57.1 months (CI 15.2–99.0) for myosteatosis (log rank p = 0.044), respectively. A relationship between sarcopenia and myosteatosis and other negative outcomes after esophagectomy could not be established.ConclusionsSarcopenia and myosteatosis before esophagectomy are associated with decreased overall survival but not with more frequent perioperative complications. Identification of patients at risk can guide therapeutic decisions and interventions aimed at replenishing muscle reserves.

Introduction The COVID-19 pandemic has strongly affected global healthcare systems. Prior epidemiological studies on different infectious diseases have shown a strong correlation between serum vitamin D levels and the incidence of certain infectious diseases. Vitamin D has an important immunomodulatory effect on innate immunity and exhibits several other mechanisms in the pathogenesis of the cytokine storm, which is one of the main contributing factors to fatality in COVID-19 patients. Methods A keyword search was conducted in the PubMed and Google Scholar research databases. The abstracts and/or full texts of selected papers were further evaluated. Articles that fulfilled the inclusion criteria were included in the systematic review. Results The 28 studies summarized in this review provide observational findings that vitamin D levels are related to the incidence, severity, and mortality rate of COVID-19 infection. The literature does not suggest that COVID-19 could be eliminated with supplementation of vitamin D, but there are implications that vitamin D deficiency might increase the risk for COVID-19 infection and severity of the disease progression. Discussion Current literature and several guidelines support the supplementation of vitamin D as a reasonable strategy for correcting and preventing vitamin D deficiency. The recommended dose for maintaining normal 25(OH)D levels by consensus is 1000 to 2000 IU vitamin D daily for at-risk teens and adults. Conclusion Vitamin D supplementation might play an important role in protecting from acute respiratory infections like the SARS CoV2, and in high-risk individuals with COVID 19 from progressing to critical clinical condition and reducing mortality.

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The number of elderly people in our population is increasing. Our job, as a society, is to respond to specific needs of the elderly and to solve them in appropriate ways. Part of the elderly population needs to be taken care of in various institutions, such as nursing homes. Nursing homes provide all