Glucagon-like peptide-1 (GLP-1) receptor agonists for weight management: A review for the gynecologic oncologist.

The use of glucagon-like peptide-1 receptor agonists (GLP-1RA) has experienced rapid growth amidst the obesity epidemic in the United States. While originally developed for glucose control in Type 2 Diabetes Mellitus, the scope of these agents now extends to encompass weight loss and cardiovascular risk reduction. GLP-1RAs have the potential to induce significant weight loss, in combination with lifestyle modifications, among adults who are overweight or obese. Furthermore, these agents demonstrate efficacy in ameliorating hyperglycemia, enhancing insulin sensitivity, regulating blood pressure, improving cardiometabolic parameters, mitigating kidney dysfunction, and potentially reducing the risk of several obesity-related cancers. Drug-related toxicity is primarily gastrointestinal and active management can prevent drug discontinuation. Obesity is associated both with an increased incidence of malignancy but also with decreased survival. More research is needed to evaluate the potential use of GLP-1RA to modify the endocrine function of adipocytes, regulate the chronic inflammatory state associated with obesity, and prospective applications in oncology. These agents can impact patients with gynecologic malignancies both through their direct mechanism of action as well as potential drug toxicity.

Surgical Management of Emphysematous Gastritis in a Postpartum Female: A Case Report and Literature Review.

Emphysematous gastritis is a form of gastritis characterized by both gastric inflammation and the presence of intramural gas. Its occurrence is rare, and its presentation is non-specific. Consequently, no definitive guidelines for management have been outlined. We herein detail the diagnosis and surgical management of a female with complicated emphysematous gastritis following a cesarean section delivery. In light of the gastric ischemia noted on esophagogastroduodenoscopy, the decision was made to proceed with surgical management to ascertain the extent of necrosis. Following a partial gastrectomy, the patient had an uneventful postoperative course and met feeding milestones. Given the high morbidity rate of emphysematous gastritis and the success of our intervention, we propose the utilization of exploratory laparoscopy/laparotomy in patients with identified or highly suspected gastric ischemia. This aids in the characterization of ischemia and guides decision-making on the extent of gastric resection (partial versus complete gastrectomy).