Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 950
Filter
1.
Nutr Neurosci ; : 1-9, 2024 Oct 02.
Article in English | MEDLINE | ID: mdl-39356211

ABSTRACT

Objectives: Children with Tourette syndrome (TS) have been shown to exhibit high levels of food selectivity; however, its association with nutritional status has yet to be explored. The current study explored macro and micronutrient intake and food selectivity among children with and without TS, using 24-hour dietary recall and the Child Eating Behaviour Questionnaire.Method: Parents of 43 children diagnosed with TS and 38 age-matched children without a clinical diagnosis completed an online 24-hour food diary.Results: Fifty-eight per cent of children with TS were identified as falling outside of the healthy BMI range (underweight = 24.2%; overweight = 27.3%; obese = 6.1%). Children with TS also consumed fewer portions of fruit and vegetables along with meeting the daily reference nutrient intake guidelines significantly less often for vitamins B3, B6 and C, selenium and phosphorus compared to children without TS.Conclusions: Understanding the nutritional risk of children with TS relative to other children is important to clinicians and health care professionals who oversee nutritional inspection in primary care, and caregivers who are worried about the impact of limited or restricted diets.

2.
Front Nutr ; 11: 1470713, 2024.
Article in English | MEDLINE | ID: mdl-39385781

ABSTRACT

Introduction: Nutritional deficiencies (NDs) manifest in various forms and are widespread globally. However, a systematic evaluation of the epidemiology of NDs across all causes and age groups in different countries and regions has not been conducted. Materials and methods: This study aimed to utilize data from the 2019 Global Burden of Disease (GBD) study to assess the burden and trends of NDs, including their incidence, prevalence, mortality, and disability-adjusted life years (DALYs). Additionally, the study evaluated health inequalities at global, regional, and national levels from 1990 to 2019. Result: In 2019, the age-standardized incidence rate of NDs was 2,207.71 per 100,000 individuals (95% UI 1,863.04-2,604.67), and the age-standardized DALYs (ASR-DALYs) was 680.12 per 100,000 individuals (95% UI 507.21-894.89). Among the causes of NDs, dietary iron deficiency had the highest ASR-DALYs and exhibited minimal variation. Children under the age of 5 years faced the greatest risk of NDs. Sex disparity was evident, with males having lower rates than females. Although the gap in the burden of NDs between regions classified as poor and wealthy decreased, disparities persist. Conclusion: These findings provide critical insights for the development of global health strategies aimed at mitigating NDs and may guide policymakers in implementing effective and economically viable interventions.

3.
Cureus ; 16(8): e66477, 2024 Aug.
Article in English | MEDLINE | ID: mdl-39246987

ABSTRACT

Subfertility, a condition marked by a reduced capacity to conceive naturally, affects a significant proportion of couples globally. Nutrition is a fundamental aspect of reproductive health, with various nutrients essential in maintaining optimal reproductive function. This comprehensive review explores the intricate relationship between nutritional deficiencies and subfertility. It examines key micronutrients such as vitamins D, E, C, and B12, as well as minerals such as zinc, iron, selenium, and magnesium, and their impacts on fertility. The review also considers macronutrients and the importance of a balanced diet in supporting reproductive health. Drawing on an extensive body of clinical evidence and studies, this review highlights how deficiencies in these nutrients can lead to hormonal imbalances, impaired gametogenesis, and suboptimal pregnancy outcomes. It discusses the efficacy of nutritional interventions, including dietary supplements and lifestyle modifications, in improving fertility. Furthermore, it addresses the emerging research on personalized nutrition and its potential to enhance reproductive outcomes. The review underscores the necessity for healthcare providers to assess and address the nutritional status of patients with subfertility. It provides practical recommendations for developing nutritional plans, counseling patients, and integrating nutritional interventions into fertility treatments. By offering a comprehensive synthesis of current evidence, this review aims to inform clinical practice and promote further research into the role of nutrition in enhancing fertility.

4.
Front Immunol ; 15: 1455907, 2024.
Article in English | MEDLINE | ID: mdl-39247185

ABSTRACT

Pembrolizumab and other immunotherapies have become central in treating metastatic colon cancer, particularly effective in patients with mismatch repair deficiencies. We report a case involving a man who initially underwent radical surgery for sigmoid colon cancer on April 27, 2011, followed by hepatic tumor resection on September 21, 2017. Post-surgery, he received eight cycles of adjuvant chemotherapy with the CAPEOX regimen and was regularly monitored through CT and MRI scans. On August 24, 2022, liver metastases were detected, and he was diagnosed with Lynch syndrome (LS) due to germline mutation in the MSH2 and EPCAM genes. He commenced treatment with 200mg of pembrolizumab intravenously every three weeks on September 2, 2022, and demonstrated a sustained response. However, after 17 cycles, he developed a treatment related adverse event (TRAE) of pancreatic endocrine dysfunction, leading to type 1 diabetes, managed with subcutaneous insulin injections. After 30 cycles of treatment, no evidence of disease was observed. This case underscores the significant clinical benefits of first-line pembrolizumab in managing hepatic metastasis in colonic carcinoma associated with LS, despite the occurrence of TRAEs. It raises critical questions regarding the optimal duration of immunotherapy following a complete or partial response and whether treatment should be discontinued upon the emergency of TRAEs. Continued research and forthcoming clinical trials with checkpoint inhibitors are expected to refine treatment protocols for LS-associated carcinoma.


Subject(s)
Antibodies, Monoclonal, Humanized , Antineoplastic Agents, Immunological , Colorectal Neoplasms, Hereditary Nonpolyposis , Liver Neoplasms , Humans , Antibodies, Monoclonal, Humanized/therapeutic use , Antibodies, Monoclonal, Humanized/administration & dosage , Male , Colorectal Neoplasms, Hereditary Nonpolyposis/drug therapy , Liver Neoplasms/secondary , Liver Neoplasms/drug therapy , Antineoplastic Agents, Immunological/therapeutic use , Colonic Neoplasms/drug therapy , Colonic Neoplasms/pathology , Middle Aged , Treatment Outcome , MutS Homolog 2 Protein/genetics , Epithelial Cell Adhesion Molecule/genetics
5.
Cureus ; 16(9): e69273, 2024 Sep.
Article in English | MEDLINE | ID: mdl-39268027

ABSTRACT

Hypomagnesemia can occasionally present with severe neurological deficiencies, and it is usually attributed to an underlying renal and/or gastrointestinal pathology. Rarely, patients may present with neurological symptoms in the absence of an obvious cause. Our case highlights the importance of considering hypomagnesemia as a primary cause of those presenting with severe neurological deficits in an intensive care unit setting, as well as the significance of conducting a thorough social and medical history on these patients to elucidate their underlying causes. We discuss the case of a 48-year-old Caucasian male who acutely presented with seizures, tremors, visual hallucinations, diplopia, personality changes, and ataxia with recurring severely low magnesium (0.4 mg/dL) at times in the absence of renal, gastrointestinal, hormonal, infectious, or autoimmune pathology.

6.
Crit Rev Food Sci Nutr ; : 1-22, 2024 Sep 13.
Article in English | MEDLINE | ID: mdl-39269149

ABSTRACT

Biofortification (increasing the micronutrient content of food before harvest) has been successfully used to nutritionally improve staple foods in low- and middle-income countries. This approach could also help address micronutrient shortfalls in at-risk populations in high-income countries (HICs), however, the potential of biofortification interventions in this context is not well understood. The aim of this scoping review is to assess the nature and extent of available research evidence on biofortified foods in relation to human consumption in HICs. Literature searches were conducted in MEDLINE, WoS, ProQuest, CINAHL, AGRIS and Epistemonikos. Forty-six peer-reviewed articles were included. Most research was conducted in the USA (n = 15) and Italy (n = 11), on cereal crops (n = 14) and vegetables (n = 11), and on selenium (n = 12) and provitamin A (n = 11). Seven research domains were identified in the literature: bioavailability (n = 17); nutrient stability (n = 11); opinions and attitudes (n = 9); functionality (n = 9); sensory properties (n = 2); safety (n = 1); and modeling (n = 1). Evidence from HICs in each domain is limited. There is a need for more research particularly in areas sensitive to the cultural and socio-economic context.

7.
Nutrients ; 16(17)2024 Sep 08.
Article in English | MEDLINE | ID: mdl-39275348

ABSTRACT

Avoidant/Restrictive Food Intake Disorder (ARFID) and food neophobia present significant challenges in pediatric healthcare, particularly among children with food allergies (FAs). These eating disorders, characterized by the persistent avoidance or restriction of food, can lead to severe nutritional deficiencies and psychosocial impairments. The presence of FAs further complicates these eating behaviors, as the fear of allergic reactions exacerbates avoidance and restrictive patterns. This comprehensive review synthesizes current knowledge on ARFID and food neophobia, focusing on their definitions, characteristics, and the unique challenges they present in the context of FAs. The review explores the critical role of healthcare professionals, especially nurses, in integrating psychological and clinical care to improve outcomes for affected children. A multidisciplinary approach, including Cognitive Behavioral Therapy (CBT) and Family-Based Therapy (FBT), is emphasized as essential in addressing the complex needs of these patients. The review also highlights the need for standardized treatment protocols and further research on the long-term outcomes of these disorders, aiming to enhance therapeutic strategies and family support systems. Effective management of ARFID and food neophobia in the context of FAs requires a holistic and integrated approach to mitigate the profound impacts on a child's growth, development, and overall well-being.


Subject(s)
Avoidant Restrictive Food Intake Disorder , Food Hypersensitivity , Humans , Food Hypersensitivity/psychology , Food Hypersensitivity/therapy , Child , Cognitive Behavioral Therapy/methods , Phobic Disorders/psychology , Phobic Disorders/therapy , Feeding Behavior/psychology , Family Therapy/methods , Child, Preschool
8.
Heliyon ; 10(17): e37009, 2024 Sep 15.
Article in English | MEDLINE | ID: mdl-39281530

ABSTRACT

The management of China's pelagic fisheries has played a crucial role in the development of these fisheries. By examining the evolution of pelagic fisheries management in China from 1985 to 2024, this study aims to examine the changes in the development trends over time. The study of the pelagic fisheries management evolution involves data collection and content analysis. The pelagic fisheries management in China can be divided into three distinct phases in chronological order: the first period (1985-1997) with the focus on accelerating the development of pelagic fisheries, the second period (1998-2015) with the focus on progressively engaging in international fisheries governance, the third period (2016-2024) with the focus on the ecological advancement of the pelagic fisheries. Nevertheless, there are still some deficiencies in pelagic fisheries management, including inadequate management, unreasonable subsidies, outdated equipment and technology, limited stakeholders engaged in management, and conflicting maritime interests with other nations. To address these deficiencies, this paper emphasizes enhancing the management system, reforming fishery subsidies, prioritizing science and technology, promoting stakeholders' engagement in management, and strengthening international collaboration in fisheries.

9.
Article in English | MEDLINE | ID: mdl-39276852

ABSTRACT

Evidence suggests that fish are more tolerant than mammals to imbalanced dietary amino acid profiles. However, the behavioral and physiological responses of fish to individual deficiencies in dietary indispensable amino acids (IDAA) remain unclear. This study examined how stomachless fish respond to diets deficient in limiting IDAA (lysine, methionine, and threonine), using Zebrafish (Danio rerio) as a model. The response to deficient diets was assessed based on; 1) growth performance and feeding efficiency; 2) feed intake; 3) expression of appetite-regulating hormones and nutrient-sensing receptors; and 4) muscle postprandial free amino acid (FAA) levels. There were 6 treatments, each with 3 replicate tanks. A semi-purified diet was formulated for each group. The CG diet was based on casein and gelatin, while the FAA50 diet had 50 % of dietary protein supplied with crystalline amino acids. Both were formulated to contain matching, balanced amino acid profiles. The remaining diets were formulated the same as the FAA50 diet, with minor adjustments to create deficiencies in selected IDAA. The (-) Lys, (-) Met, and (-) Thr diets had lysine, methionine, and threonine withheld from the FAA mix, respectively, and the Def diet was deficient in all three. The juvenile Zebrafish were fed to satiation 3 times daily from 21 to 50 days-post-hatch. Results showed that 50 % replacement of dietary protein with crystalline amino acids significantly reduced growth of juvenile Zebrafish. There were no significant differences in growth between the FAA50 group and groups that received deficient diets. The deficiency of singular IDAA did not induce significant changes in feed intake; however, the combined deficiency in the Def diet caused a significant increase in feed intake. This increased feed intake led to decreased feeding efficiency. A significant decrease in feeding efficiency was also observed in the (-) Lys group. There was an observed upregulation of neuropeptide Y (NPY), an orexigenic hormone, in the Def group. Overall, results from this study suggest stomachless fish increase feed intake when challenged with IDAA-deficient diets, and the regulation of NPY might play a role in this response.


Subject(s)
Zebrafish , Animals , Zebrafish/physiology , Animal Feed/analysis , Methionine/deficiency , Methionine/administration & dosage , Methionine/metabolism , Eating , Amino Acids/metabolism , Amino Acids, Essential/deficiency , Amino Acids, Essential/administration & dosage , Amino Acids, Essential/metabolism , Diet/veterinary , Threonine/deficiency , Threonine/metabolism , Lysine/deficiency , Lysine/metabolism , Lysine/administration & dosage , Feeding Behavior
10.
Pediatr Clin North Am ; 71(5): 981-998, 2024 10.
Article in English | MEDLINE | ID: mdl-39343505

ABSTRACT

Obesity is a chronic, complex, and multifactorial disease. Currently, approximately 6% have severe obesity with higher rates seen among racial/ethnic minority subgroups and in rural communities. Severe obesity is associated with cardiometabolic, psychologic, and musculoskeletal comorbidities. Metabolic and bariatric surgery is an effective treatment option for adolescents endorsed by major pediatric organizations. The most common procedure is the vertical sleeve gastrectomy. Pre-operative evaluation includes an in-depth medical, nutrition, physical activity and psychosocial assessment, with a care plan developed by a multidicplinary team with the adolescent and caregiver. The post-operative plan should include monitoring for surgical complications, weight regain, micronutrient deficiencies, psychologic challenges, and transition to adult care.


Subject(s)
Bariatric Surgery , Pediatric Obesity , Humans , Adolescent , Bariatric Surgery/methods , Pediatric Obesity/surgery , Obesity, Morbid/surgery , Obesity, Morbid/psychology , Gastrectomy/methods
11.
Front Nutr ; 11: 1466388, 2024.
Article in English | MEDLINE | ID: mdl-39296506

ABSTRACT

Scurvy, a rare disease resulting from vitamin C deficiency, can occur in individuals with restrictive eating disorders like anorexia nervosa (AN), leading to severe health complications. This review explores the complex relationship between scurvy and AN, highlighting the overlapping symptoms and challenges in diagnosis and treatment. Vitamin C is essential for collagen synthesis, immune function, and neurotransmitter production, and its deficiency manifests as fatigue, gingival bleeding, joint pain, and perifollicular hemorrhages. AN exacerbates these symptoms through extreme food restriction, causing severe nutritional deficiencies. Analyzing nine case reports, this review reveals that patients with co-occurring AN and scurvy often present with gastrointestinal, psychiatric, and dermatological symptoms. Treatment with vitamin C supplementation typically results in rapid symptom improvement. However, the malnutrition inherent in AN complicates the clinical picture, making timely diagnosis and intervention crucial. This review underscores the importance of a comprehensive, multidisciplinary approach to managing these conditions, emphasizing the need for early recognition and treatment to prevent severe complications. Future research should include a more diverse patient population to enhance understanding of the interplay between AN and scurvy, aiming to improve patient outcomes through tailored treatment strategies.

12.
Children (Basel) ; 11(8)2024 Aug 14.
Article in English | MEDLINE | ID: mdl-39201924

ABSTRACT

Congenital or acquired hand differences, including unilateral below-elbow deficiencies, present complex challenges in pediatric rehabilitation. Surgical management and prosthetic provision represent a big challenge to find a good balance for guaranteeing optimal hand function. There is no specific assessment tool for measuring these aspects in the Italian context. The present study investigates the psychometric properties of the ABILHAND-Kids in children with congenital unilateral below-elbow deficiencies and acquired amputation of the upper limb. We measure internal consistency using Cronbach coefficient alpha and the intraclass correlation coefficient (ICC) for measuring test-retest reliability. Differences in hand function in both children with acquired or congenital diseases were also investigated. Participants to the study were 107 (49 F and 58 M) children, with a mean (SD) age of 8.88 (4.25). For test retest reliability, conducted on a sub-sample of 58 children, the ICC was 0.92, while for internal consistency, the Cronbach coefficient alpha was 0.90. We did not find statistically significant differences in scoring (p = 0.33) in the use (mean 29.25 SD 6.58) or non-use of a prosthetic device (mean 30.74 SD 7.43), while statistically significant differences were found in hand function (p < 0.01) for children who had a congenital impairment (mean 31.87 SD 6.49) and children who had an acquired amputation (mean 27.77 SD 6.60). In conclusion, the ABILHAND-Kids showed good internal consistency and reliability and can capture differences in hand function in children with both congenital and acquired hand disorders.

13.
Nutrients ; 16(16)2024 Aug 19.
Article in English | MEDLINE | ID: mdl-39203898

ABSTRACT

Inflammatory bowel disease (IBD) includes Crohn's disease (CD) and ulcerative colitis (UC). These diseases are characterized by inflammation, which may be a consequence of changes in the intestinal microbiota and lead to mineral and vitamin deficiencies. The aims of this study were to determine the level of dietary supplement intake in children with IBD and to determine the influence of factors such as sex, nutritional status, diet, and other comorbidities on supplement intake. The study was conducted from May 2022 to September 2023 and was a prospective study. The group of children with IBD that ultimately qualified for the study numbered 96, and the control group numbered 30. The children who participated in the study were aged 4-18 years. Most parents of children with IBD (81.4%) declared that they use supplementation for their children, while 75% of parents of children without IBD declared giving their children nutritional supplements. Vitamins in both groups were most often given to children as dietary supplements (p = 0.018), including vitamin D. Depending on the diet used, the intake of vitamin B6 (p = 0.018), vitamin E (p = 0.040) and iron (p = 0.006) was significantly different among children with IBD. Statistical significance (p = 0.021) was observed for supplementation use and disease stage among children with IBD. For 80.2% of parents of children with IBD, the main reason for using supplements was a doctor's recommendation. In the control group, 43.3% of parents indicated that the main reason for using supplements was to correct nutritional deficiencies. Supplementation was common in both groups, but attention should be paid to other current diseases in children with IBD and to nutritional status. In our opinion, educating parents about supplementation is important, especially among parents of children with IBD.


Subject(s)
Dietary Supplements , Inflammatory Bowel Diseases , Nutritional Status , Humans , Male , Female , Child , Adolescent , Poland , Pilot Projects , Child, Preschool , Prospective Studies , Inflammatory Bowel Diseases/diet therapy , Colitis, Ulcerative , Vitamins/administration & dosage , Diet/methods , Crohn Disease/diet therapy , Parents
15.
Obes Surg ; 34(10): 3608-3618, 2024 Oct.
Article in English | MEDLINE | ID: mdl-39141187

ABSTRACT

INTRODUCTION: Pregnant women with a history of metabolic bariatric surgery (MBS) are at high risk of developing nutrient deficiencies, leading to greater challenges to reach nutritional requirements. This study compared nutrient status of women using specialized "weight loss surgery" multivitamin supplementation (WLS-MVS) to those using standard supplementation (sMVS) during pregnancy following MBS. METHODS: Multicenter observational cohort study including 119 pregnant women at 41.0 (18.5-70.0) months after Roux-en-Y gastric bypass (RYGB, n = 80) or sleeve gastrectomy (SG, n = 39). Routine blood samples were analyzed every trimester (T1, T2, T3), and micronutrient serum levels were compared between WLS-MVS and sMVS users. RESULTS: During pregnancy after RYGB, WLS-MVS users demonstrated higher serum concentrations of hemoglobin (7.4 [7.2, 7.5] vs. 7.0 [6.8, 7.3] mmol/L), ferritin (23.2 [15.0, 35.7] vs. 13.7 [8.4, 22.4] µg/L), and folic acid (31.4 [28.7, 34.2] vs. 25.4 [21.3, 29.4] nmol/L) and lower serum vitamin B6 levels (T1: 90.6 [82.0, 99.8] vs. 132.1 [114.6, 152.4] nmol/L) compared to sMVS users. Iron deficiencies and elevated serum vitamin B6 levels were less prevalent in the WLS-MVS group. During pregnancy after SG, WLS-MVS users showed higher serum vitamin D concentrations (89.7 [77.6, 101.8] vs. 65.4 [53.3, 77.4] nmol/L) and lower serum vitamin B1 concentrations (T2: 137.4 [124.2, 150.6] vs. 161.6 [149.0, 174.1] nmol/L, T3: 133.9 [120.1, 147.7] vs. 154.7 [141.9, 167.5] nmol/L) compared to sMVS users. CONCLUSION: Low maternal concentrations of micronutrients are highly prevalent during pregnancy after MBS. The use of specialized multivitamin supplementation generally resulted in higher serum levels during pregnancy compared to standard supplementation. Future research is needed to investigate how supplementation strategies can be optimized for this high-risk population.


Subject(s)
Dietary Supplements , Nutritional Status , Obesity, Morbid , Pregnancy Complications , Humans , Female , Pregnancy , Adult , Obesity, Morbid/surgery , Obesity, Morbid/blood , Pregnancy Complications/blood , Gastric Bypass , Vitamins/blood , Vitamins/administration & dosage , Bariatric Surgery , Cohort Studies , Gastrectomy , Folic Acid/blood , Folic Acid/administration & dosage
16.
Article in English | MEDLINE | ID: mdl-39147326

ABSTRACT

BACKGROUND: Agammaglobulinemia due to variants in IGLL1 has traditionally been considered an exceedingly rare form of severe B-cell deficiency, with only 8 documented cases in the literature. Surprisingly, the first agammaglobulinemic patient identified by newborn screening (NBS) through quantification of kappa-deleting recombination excision circles harbored variants in IGLL1. OBJECTIVE: We comprehensively reviewed clinical and immunologic findings of patients with B-cell deficiency attributed to variants in IGLL1. METHODS: NBS programs reporting the use of kappa-deleting recombination excision circle assays, the European Society for Immunodeficiencies Registry, and authors of published reports featuring patients with B-cell deficiency linked to IGLL1 variants were contacted. Only patients with (likely) pathogenic variants, reduced CD19+ counts, and no alternative diagnosis were included. RESULTS: The study included 13 patients identified through NBS, 2 clinically diagnosed patients, and 2 asymptomatic siblings. All had severely reduced CD19+ B cells (< 0.1 × 109/L) at first evaluation, yet subsequent follow-up assessments indicated residual immunoglobulin production. Specific antibody responses to vaccine antigens varied, with a predominant reduction observed during infancy. Clinical outcomes were favorable with IgG substitution. Two patients successfully discontinued substitution therapy without developing susceptibility to infections and while maintaining immunoglobulin levels. The pooled incidence of homozygous or compound heterozygous pathogenic IGLL1 variants identified by NBS in Austria, Czechia, and Switzerland was 1.3:100,000, almost double of X-linked agammaglobulinemia. CONCLUSION: B-cell deficiency resulting from IGLL1 variants appears to be more prevalent than initially believed. Despite markedly low B-cell counts, the clinical course in some patients may be milder than reported in the literature so far.

17.
Am J Med Genet A ; : e63833, 2024 Aug 09.
Article in English | MEDLINE | ID: mdl-39119839

ABSTRACT

Glycosylphosphatidylinositols (GPIs) are a type of glycolipid responsible for anchoring many important proteins to the cell membrane surface. Defects in the synthesis of GPIs can lead to a group of multisystem disorders known as the inherited GPI deficiencies (IGDs). Homozygosity for the c.-270C > G variant in the promoter of PIGM has been associated with a IGD subtype known as glycosylphosphatidylinositol biosynthesis defect-1 (GPIBD1). The several cases reported in the literature have been described to have a milder neurologic phenotype in comparison to the other IGDs and have been treated with sodium phenylbutyrate with some degree of success. These patients typically present with portal and hepatic vein thrombosis and mostly develop absence seizures. Here we describe a patient homozygous for a nonsynonymous variant in PIGM who deceased at 9 weeks of life and had multiple physical dysmorphisms (rocker bottom feet, midline cleft palate, thickened and lichenified skin), portal vein thrombosis, CNS structural anomalies (progressive multicystic encephalomalacia and ventriculomegaly), and a neurological phenotype of a diffuse encephalopathy. This is the first known case report of a PIGM-related IGD/CDG due to a coding variant.

18.
J Clin Med ; 13(15)2024 Aug 05.
Article in English | MEDLINE | ID: mdl-39124845

ABSTRACT

Celiac disease (CeD) is a chronic inflammatory disease of the small intestine, produced by ingesting dietary gluten products in susceptible people. Gluten causes an impairment of the mucosal surface and, consequently, an abnormal absorption of nutrients. Although malabsorption of essential nutrients is a major risk factor for various CeD-associated morbidities, genetic, immunological, and environmental factors also play an important role. The clinical presentation of CeD widely varies and can range from asymptomatic to full-blown symptoms due to the multi-system nature of CeD. The typical gastrointestinal (GI) manifestations of CeD include abdominal pain, diarrhea, bloating, and weight loss, but several hepatobiliary manifestations and a poor nutritional status have also been described. Currently, a gluten-free diet (GFD) is the only current evidence-based treatment that leads to the complete recovery of mucosal damage and the reversibility of its progression. Conversely, undiagnosed CeD might have severe consequences in children as well as in adult patients. This narrative overview aims to characterize the GI and hepatobiliary manifestations, nutritional deficiencies, and delayed pediatric development associated with unrecognized CeD in order to identify it promptly. Moreover, the role of GFD and how it could prevent long-term complications of CeD are described.

19.
Cureus ; 16(7): e64525, 2024 Jul.
Article in English | MEDLINE | ID: mdl-39139339

ABSTRACT

Pituitary apoplexy is a rare but potentially life-threatening condition of sudden hemorrhage or infarction within the pituitary gland that results in symptoms of acute onset such as severe headache, visual impairment, and hormonal deficiencies. Though more common in adults, the same criteria for diagnostic and management dilemmas apply to pediatric cases. We present the case of a nine-year-old boy presenting with acute-onset severe headache and significant visual deterioration suggestive of pituitary apoplexy. An emergency MRI was performed, which showed a hemorrhagic sellar and suprasellar mass compressing the optic chiasm. Given the severe visual symptoms in this case, emergency surgical intervention was indicated. Decompression and gross total resection of the tumor were successfully attained using the endoscopic transnasal transsphenoidal approach by a multidisciplinary team. After the surgery, there was a significant improvement in the visual field, especially regarding the right eye's nasal hemifield, and the motor strength and consciousness remained stable. This case underscores the importance of early diagnosis and expedited surgical management in pediatric pituitary apoplexy. The transnasal transsphenoidal approach is practical for maximal decompression of the optic apparatus and reduces the risk of long-term visual deficits. In addition, it points out the need for coordinated, multidisciplinary treatment with the participation of neurosurgeons, endocrinologists, and pediatricians both for immediate and long-term consequences, including potential hormonal deficiencies. The report emphasizes the need for vigilance and prompt intervention in pediatric presentations, unlike the index case, for better outcomes and to avoid permanent morbidity.

20.
Cancer Treat Res ; 191: 119-144, 2024.
Article in English | MEDLINE | ID: mdl-39133406

ABSTRACT

The effect of nutrition in the development and prognosis of cancer has received a lot of attention. Research shows taking vitamins, which are powerful antioxidants, can significantly lower the risk of cancers. Nutritional supplements suited to a patient's background, genetics, diet, tumour histology, and therapy may be beneficial in some cases. A poor diet may have a negative impact on immunity and treatment tolerance, decreasing the efficacy of chemotherapy in destroying malignant cells. Most cancer patients now take vitamins to supplement regular treatment and/or to decrease side effects from the medicine as well as the underlying ailment. This is a new development in recent decades, whereas taking nutritional supplements while receiving cancer treatment may increase the success of chemotherapy. To enhance the quality of life, lengthen the survival rate, and sustain immunotherapy compliance, additional study into the use of micronutrients in medical treatment is required for cancer patients. The main purpose of this book chapter was to highlight the role of vitamins in cancer and to establish a solid foundation for future research on this exciting topic. The possible impact of some vitamins in various malignancies such as colorectal, breast, prostate, lung, pancreatic, and stomach cancers are investigated.


Subject(s)
Dietary Supplements , Micronutrients , Neoplasms , Vitamins , Humans , Neoplasms/prevention & control , Micronutrients/therapeutic use , Vitamins/therapeutic use
SELECTION OF CITATIONS
SEARCH DETAIL