To examine the overlap of sarcopenic obesity (SO), defined by two different diagnostic criteria, in older adults with diabetes and to investigate its association with higher-level functional capacity. We conducted a cross-sectional study using retrospective data from patients with diabetes aged ≥ 60 years who were hospitalized at Ise Red Cross Hospital, irrespective of diabetes type, disease duration, and diabetes-related complications. The data collection period was one year, beginning in July 2020. SO was assessed using the criteria of the Japanese Working Group on Sarcopenic Obesity (JWGSO), which adjusts muscle mass by body mass index; the Asian Working Group for Sarcopenia 2019 (AWGS), which adjusts muscle mass by height; and body fat percentage. Body fat percentage and skeletal muscle mass were measured using multi-frequency bioelectrical impedance analysis. Higher-level functional capacity was evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Using multiple regression analysis, we calculated the standardized partial regression coefficient (β) for the association between SO and higher-level functional capacity, adjusting for age, gender, diabetes etiology, HbA1c, number of comorbidities, living alone, mild cognitive decline, and diabetic medications. The estimated sample size was approximately 300 patients. The study included 345 patients; 61 (17.6
Introduction:Despite the use of narrow-band imaging, comprehensive endoscopic evaluation of the laryngopharynx in the endoscopy suite remains challenging because of its complex anatomical structure, limited working space, and reactions such as gagging and coughing. Consequently, minute synchronous neoplasms may occasionally be overlooked during the initial endoscopic assessment. We hypothesized that argon-plasma coagulation (APC) could serve as a minimally invasive treatment for minute synchronous neoplasms of the head and neck detected during endoscopic laryngopharyngeal surgery combined with endoscopic submucosal dissection (ELPS/ESD) for primary lesions. Case Presentation:We report three cases of pharyngeal cancer treated with ELPS/ESD under general anesthesia: an 82-year-old man, a 73-year-old man, and a 40-year-old woman. During intraoperative endoscopic observation, 9 minute lesions measuring 3-7 mm that had not been detected in the endoscopy suite were identified in 3 patients. These lesions were immediately treated with APC, a non-contact technique that uses ionized argon gas to coagulate abnormal tissue. In Cases 1, 2, and 3, the lengths of hospital stay were 10, 11, and 6 days, respectively, and the follow-up periods were 9 months, 6 months, and 6 months, respectively. Within this limited follow-up period, no post-procedural bleeding, post-procedural hoarseness, or post-procedural swallowing dysfunction was observed. Conclusion:Based on this small case series with limited follow-up, intraoperative APC may be a feasible adjunctive approach for the ablation of minute synchronous lesions detected during ELPS/ESD for pharyngeal cancer.
