Background Previous reports suggested that selective serotonin reuptake inhibitors (SSRI) could decrease the activity of 5-hydroxytryptamine type 3 (5-HT3) antagonists against acute chemotherapy-induced nausea and vomiting (CINV), possibly through serotonin accumulation for 5-HT3 receptors. Patients and methods Chemonaive cancer patients receiving SSRI and antiemetic agents, including the 5-HT3 antagonist ondansetron and the neurokinin 1 (NK1) antagonist aprepitant for highly emetogenic chemotherapy (etoposide?platinum), were matched to control patients for the following variables: age, gender, primary tumor, past history of gestational emesis, chronic intake of benzodiazepines and/or corticosteroids, chronic alcohol intake, and aprepitant use. The primary evaluation criterion was the occu...

Abstract in english Objectives: Despite the extensive amount of published literature upon burning symptoms in patients with clinically healthy appearance of the oral mucosa, as well as burning mouth syndrome (BMS) itself, they both remain still challenging topics. The aim of this study was to determine the real prevalence of "true" BMS in comparison to other patients with burning symptoms with clinically healthy appearance of the oral mucosa and then to compare "true" BMS patients with healt (more) hy controls regarding gastritis and intake of anxiolytics and angiotensin converting enzyme inhibitors. Study design: In 150 patients with burning symptoms of clinically healthy oral mucosa, local and systemic investigations were performed and they included detection of candidal infection, salivary flow rate, presence of oral galvanism and parafunctional habits as well as complete blood count, serum ferritin, serum glucose levels, serum antibodies to Helicobacter pylori together with detailed medical history with special regard to medication intake. After "true" BMS patients were identified they have been compared to the controls with regard to the presence of gastritis and the intake of anxiolytics and angiotensin converting enzyme inhibitors. Results: Our results show that gastritis were significantly more present among "true" BMS patients and that they also significantly more intake anxiolitics, when compared to the control group. Conclusions: Our findings might lead to the conclusion that every "true" BMS patient should be referred to the gastroenterologist and psychiatrist.

The authors report a case of acute pancreatitis, complicated by pancreatic-peritoneal fistula and ascites in 26 year old man, with a history of excessive alcoholic intake. Biochemical investigation of ascitic and pleural fluids, which revealed markedly elevated activity of pancreatic enzymes and protein indicated their pancreatic origin. After 25 days of treatment with somatostatin and parenteral nutrition, the condition of the patient improved and he was dismissed home. PMID:8755844

J Oral Pathol Med (2010) 39: 420-423 Background: Recurrent aphthous stomatitis (RAS), commonly referred to as canker sores, is a very common and painful oral mucosal disease. Although the etiology of RAS is not well understood, a number of factors may play a role, including nutritional deficiencies. The objective of this study was to compare dietary vitamin intake in RAS patients to that of a control group. Methods: One hundred subjects, who had suffered at least three episodes of minor RAS in the previous 12 months, completed a detailed Diet History Questionnaire designed and validated by the US National Institutes of Health. DietCalc software was used to calculate daily dietary intakes of nine different vitamins in the study subjects. Daily intakes were energy-adjusted and compared to ag...

Abstract Background. The incidence of new-onset atrial fibrillation (AF) is increased by uncontrolled hypertension, and antihypertensive treatment reduces new-onset AF. However, it is unclear whether alcohol intake and smoking influence the risk of new-onset AF during antihypertensive treatment. Methods. In the Losartan Intervention For Endpoint reduction in Hypertension (LIFE) study, a double-blinded, randomized, parallel-group study, 9193 hypertensive patients with electrocardiogram (ECG)-documented left ventricular hypertrophy (LVH), randomized to once-daily losartan- or atenolol-based antihypertensive therapy were followed for a mean of 4.8 years. At baseline, 8831 patients (54% women, mean age 67 years, mean blood pressure 174/98 mmHg after placebo run-in) had neither a history of AF nor AF on ECG, and they were thus at risk of developing this condition during the study. Results. New-onset AF occurred in 353 (4%) patients. Univariate Cox analyses showed that intake of alcohol > 10 units/week compared with less or no alcohol intake predicted new-onset AF (Hazard ratio, HR = 1.60 [95% CI 1.02-2.51], p = 0.043). Multivariate Cox regression analysis showed that intake of alcohol > 10 units/week predicted new-onset AF (p = 0.010) independently of most other univariate predictors, except when also baseline serum cholesterol, serum potassium and urinary albumin/creatinine ratio were included in the model (HR = 1.60 [95% CI 0.94-2.72], p = 0.081). Impact of smoking was not significant in Cox univariate or multivariate analyses, and there were no significant interactions between high alcohol intake and either smoking or gender on the risk of getting AF. Conclusions. Up to 10 drinks of alcohol per week appears to be safe with respect to the risk for AF in hypertensive patients with LVH. Our data suggest that alcohol intake above this level may be marginally deleterious, while no effect of smoking on risk of AF was detected in hypertensive patients with LVH.

Obtaining the desired dry weight in dialysis patients is challenging once residual diuresis has disappeared, considering the trend of increasing dietary salt intake and shortening dialysis time over the last 40 years. We describe the case of a 55-year-old patient of Sudanese origin, who presented excessive interdialytic weight gain and hypertension on maintenance hemodialysis. After failure of conservative measures, a therapy of daily hot water baths of 30minutes each on non-dialysis days was introduced. All clinical parameters improved, including potassium profile. In this article, we review the history, pathophysiological mechanisms, efficacy and possible side effects of this interesting, somewhat forgotten technique.

ObjectiveTo investigate whether lifestyle factors such as increased dietary intake of micronutrients reduce the risks of sperm DNA damage, and whether older men benefit more than younger men. DesignCross-sectional study design with equalized assignments into age groups. SettingNational laboratory and university. Patient(s)Nonclinical group of 22-80-year-old nonsmoking men (n = 80) who reported no fertility problems. Main Outcome Measure(s)Sperm DNA damage measured by alkaline and neutral DNA electrophoresis (i.e., sperm Comet assay). Result(s)Sociodemographics, occupational exposures, medical and reproductive histories, and lifestyle habits were determined by questionnaire. The average daily dietary and supplement intake of micronutrients (vitamin C, vitamin E, b-carotene, zinc, and folate...

Background & aim: Disease-related malnutrition is known to negatively affect clinical outcomes. The aim of the present study was to evaluate the prevalence of malnutrition in a cohort of outpatients affected by Systemic Sclerosis (SSc) and its association with clinical variables. Methods: One hundred sixty SSc patients were consecutively evaluated. The following clinical variables were assessed: disease duration, activity and severity, treatments, functional status, gastrointestinal involvement. Nutritional assessment included: body mass index (BMI), weight loss (WL) history, nutritional intakes and serum prealbumin. Malnutrition was defined as BMI = 10%. Results: Prevalence of malnutrition was 15% (10-21%). Logistic regression showed that malnutritio...

A 57-year-old man with chronic alcoholism was admitted to our hospital due to disturbance of consciousness and polyradiculitis. Laboratory examination revealed metabolic acidosis, hypokalemia and hypophosphataemia. Alcoholic ketoacidosis is a common disorder in alcoholic patients. All patients present with a history of heavy alcohol misuse, preceding a bout of particularly excesive intake, which had been terminated by nausea, vomiting and abdominal pain. The most important laboratory results are: normal or low glucose level, metabolic acidosis with a raised anion GAP, low or absent blood alcohol level and urinary ketones. The greatest threats to patients are: hypovolemia, hypokaliemia, hypoglucemia and acidosis. Alcohol abuse may result in a wide range of electrolyte and acid-base disorders including hypophosphataemia, hypomagnesemia, hypocalcemia, hypokalemia, metabolic acidosis and respiratory alkalosis. Disturbance of consciousness in alcoholic patients is observed in several disorders, such drunkenness, Wernicke encephalopathy, alcohol withdrawal syndrome, central pontine myelinolysis, hepatic encephalopathy, hypoglucemia and electrolyte disorders. PMID:23114957

The food that NASA's early astronauts had to eat in space is a testament to their fortitude. .... rehydrating foods and beverages, and the galley oven is used for warming foods to the .... improve the astronauts' dietary intake. Throughout history ...

Objective: To determine factors that may potentially predict a prolonged hospital stay after scheduled tonsillectomy in the pediatric population. Study Design: Retrospective chart review. Subjects and Methods: A review of pediatric patients who had undergone a tonsillectomy at a tertiary medical center from July 2007 to November 2010 was made. Preoperative variables were analyzed to determine predictors of prolonged hospital stay (defined as >24 h) that may have influenced their length of stay. Setting: Tertiary care medical center. Results: 827 patient charts were reviewed. One hundred and one patients (12.2 %) had hospital stays >24 h. Indications for tonsillectomy included obstructive sleep apnea (69.2 %), tonsillitis (13.8 %), and tonsillar asymmetry (0.9 %). Seventy-seven (76.2 %) patients of the extended stay group had a delayed discharge because of poor oral intake. Fever and respiratory complications accounted for 0.5 and 1.8 % respectively of those patients who had extended stays. Patients with extended stays were younger (p < 0.001) and weighed less (p < 0.001). Patients with a history of sickle cell crises, reactive airway disease, bronchodilator use, and anti-reflux medication use (p < 0.05) were more likely to have a prolonged hospital stay. Conclusion: Factors from the history and physical of pediatric patients may predict which children are at higher risk for extended hospital stays after routine tonsillectomy. Predictors of extended stays include those under the age of four and children weighing <20 kg, those with a history of sickle cell crises or reactive airway disease, and those using bronchodilators or anti-reflux medication. PMID:23001435

Few case series studies have addressed the issue of treatment response in patients with obsessive-compulsive disorder (OCD) and comorbid post-traumatic stress disorder (PTSD), and there are no prospective studies addressing response to conventional treatment in OCD patients with a history of trauma (HT). The present study aimed to investigate, prospectively, the impact of HT or PTSD on two systematic, first-line treatments for OCD. Two hundred and nineteen non-treatment-resistant OCD outpatients were treated with either group cognitive-behavioral therapy (GCBT n?=?147) or monotherapy with a selective serotonin reuptake inhibitor (SSRI n?=?72). Presence of HT and PTSD were assessed at intake, as part of a broader clinical and demographical baseline characterization of the sample. Severity a...

Postural orthostatic tachycardia syndrome (POTS) is characterised by the development of excessive tachycardia on standing with maintained blood pressure. We report a case of POTS in a 20-year-old girl with type 1 diabetes who presented with a 3-week history of lethargy, fatigue and orthostatic intolerance. Examination revealed a postural rise in heart rate of over 50 bpm with maintained blood pressure. This was associated with symptoms of light-headedness. Cardiac structure and function as assessed by ECG and ECHO were normal as was thyroid and adrenal function. POTS was confirmed with tilt table testing. Treatment was initiated with increased fluid intake, fludrocortisone and bisoprolol with improvement. POTS is a disabling condition which can significantly limit a patient's activities and working capacity and should be considered in a young, otherwise well patient who presents with orthostatic intolerance and a postural rise in heart rate. PMID:21686452

Treatment of chronic hepatitis C infection (HCV(+) ) has historically been shown to be less effective in patients with a heavy drinking history. The effect of moderate and heavy alcohol use on treatment with pegylated interferon-alpha and ribavirin (P/R) in an insured household population has not been previously reported. We investigated the effect of alcohol on treatment outcome in a cohort of 421 treatment-naïve HCV(+) patients, members of an integrated health care plan treated with P/R between January 2002 and June 2008. A detailed drinking history was obtained for 259 (61.5%) eligible patients. Regular drinking was reported by 93.1% of patients before HCV diagnosis, by 30.9% between HCV diagnosis and treatment, by 1.9% during treatment, and 11.6% after the end of treatment. Heavy drinking patterns were reported by 67.9%, 63.5% of patients drank more than 100 kg of ethanol before initiating HCV treatment, and 29.3% reported abstaining less than the required 6 months before treatment. Despite these reports of heavy drinking, sustained virological responses (SVRs) were obtained in 80.2% of patients with HCV genotypes 2 or 3 and 45.1% of patients with genotypes 1, 4, or 6. Pretreatment drinking patterns and total alcohol intake were both unrelated to SVR rates. Abstaining less than 6 months before treatment was related to lower SVR rates in moderate, but not heavy, drinkers. HCV treatment relapse was unrelated to drinking after treatment ended. Conclusion: The amount of alcohol consumed before HCV treatment did not have a negative effect on treatment outcomes in our population. A history of heavy drinking should not be considered a deterrent to HCV treatment in members of an integrated health care plan who are closely monitored. (HEPATOLOGY 2012). PMID:22488513

In our examination of the distribution of abdominal fat, dietary intake and biochemical data in patients with nonalcoholic fatty liver disease (NAFLD), non-obese NAFLD patients without insulin resistance presented a characteristic pattern of dietary intake. Dietary cholesterol intake was superabundant in non-obese patients compared with obese patients, although total energy and carbohydrate intake was not excessive. Namely, excess cholesterol intake appears to be one of the main factors associated with NAFLD development and liver injury. Therefore, the control of dietary cholesterol intake may lead to an improvement in NAFLD, and the NPC1L1 inhibitor ezetimibe might be a promising treatment for NAFLD. We review one pathogenic aspect of lipid metabolism dysregulation in NAFLD and survey new strategies for NAFLD treatment based on the modification of cholesterol metabolism. PMID:11961152

Amyotrophic lateral sclerosis (ALS) alters nutritional state, energy intake and energy expenditure. This article aims at reviewing present knowledge on these topics in order to determine energy requirements for maintaining a neutral energy balance in ALS patients. Maintaining a neutral energy balance prevents malnutrition and its complications and may improve physical functioning, quality of life and survival. Prevalence of malnutrition varies between 16 and 55% in ALS patients. Energy intakes are below recommended dietary allowances in 70% of ALS patients at least. These elements suggest a chronic negative energy balance with an imbalance between requirements and intakes. While insufficient intakes can be compensated with nutritional support, the energy requirements are unclear. Studies g...

Amoebiasis is a common cause of non-specific colitis in the Philippines. The prevalence of Clostridium difficile infection with colitis is unknown. Empiric use of metronidazole for colitis treatment is widely practiced. We investigated the association of C. difficile or Entamoeba histolytica infection with endoscopically/histopathologically proven colitis among adults in the Philippines. Two hundred and ten patients undergoing colonoscopy were enrolled. Demographic and clinical data were reviewed. Stool specimens were assayed for C. difficile and E. histolytica by ELISA. Microscopy was performed. The mean age of the patients was 53 y (range: 19-88 y) and 53% were male. Colitis was diagnosed in 39 of 205 patients. Clostridium difficile, E. histolytica and parasites were seen in 17 (43.6%), 10 (25.6%) and 11 (28.2%), respectively, of patients with colitis compared with 36 (21.7%; p=0.005), 13 (7.8%; p=0.001) and 56 (33.7%; p=0.51), respectively, of those without colitis. Diarrhoea and antibiotic intake history were significantly more common among patients with colitis than those without (43.6% and 20.5% vs 18.1% and 5.4%; p=0.001 and p=0.006, respectively). The mean duration of diarrhoea was 2.53 d shorter among patients with colitis. The most frequent antibiotics taken were fluoroquinolones and metronidazole (50% and 40% of antibiotic courses, respectively, in patients with colitis). This study suggests that C. difficile infection is common and might be overlooked in settings where amoebiasis and intestinal parasitism are endemic. PMID:22657531

OBJECTIVE: The authors determined the prevalence of foreign body granulomas in intra-abdominal adhesions in patients with a history of abdominal surgery. PATIENTS AND METHODS: In a cross-sectional, multicenter, multinational study, adult patients with a history of one o...

Orthostatic hypotension is very common in the elderly. It increases morbidity and is an independant predictor of all cause mortality. It is defined as a fall in systolic blood pressure greater than 20 mm Hg or a fall in diastolic blood pressure greater than 10 mm Hg within 3 minutes of standing. Symptoms include light headedness, weakness, blurred vision, fatigue and lethargy and falls. Most patients have orthostatic hypotension due to non neurogenic causes. Drugs like antihypertensives and tricyclic antidepressants are very common causes of orthostatic hypotension. Diagnosis is based on the history and a thorough clinical examination. Based on the history and physical examination, further testing of the heart, kidneys and autonomic nervous system may be required in selected patients. Non pharmacological methods like slow position change, increased fluid and sodium intake, compression stockings and elevation of head of the bed are the key to management of orthostatic hypotension. After these methods, pharmacological treatment with fludrocortisone and midodrine should be tried. Other drugs like desmopresin acetate, xamoterol, erythropoetin and ocreotide can be used as second line agents in selected patients. PMID:16307360

Oral allergy syndrome (OAS) is defined as the symptoms of IgE-mediated immediate allergy localized in the oral mucosa, and the characteristics depend on the lability of the antigen. Another term used for this syndrome is pollen-food allergy (PFS); the patient is sensitized with pollen via the airways and exhibits an allergic reaction to food antigen with a structural similarity to the pollen (class 2 food allergy). In addition to PFS, latex-fruit syndrome is also well-known as the disease exhibiting OAS. In treating the condition, it must be noted that most but not all symptoms of PFS are those of OAS. In many cases, antigens become edible by heating, but some are resistant to heating. Also, since the exacerbation of atopic dermatitis is occasionally observed after the intake of cooked antigens in asymptomatic individuals, careful inquiry of the history is important in designing the treatment. Immunotherapy against the cross-reacting pollen has also been attempted in PFS.   

A 77-year-old male with chronic hepatitis and liver cirrhosis underwent a right middle-lower lobectomy and lymph node dissection because of non-small cell carcinoma of the lung. On the 1st post-operative day (POD1), a large quantity of chylous pleural effusion was recognized after he initiated oral intake. The diagnosis was postoperative chylothorax. Conservative therapy including a medium chain tryglyceride diet and total parental nutrition were not effective. Considering of the patient's past history, we decided to continue conservative therapy using octreotide acetate on POD7. After administration of the octreotide acetate, the volume of chylous pleural effusion gradually decreased. The chest tube was removed on POD19. Octeotide acetate should be a choice for the conservative treatment of postoperative refractory chylothorax. PMID:22374601

Vitamin D deficiency is common in older women and can negatively impact bone status. A simple method by which clinicians and researchers can evaluate a patient's vitamin D dietary intake could help identify individuals at risk for vitamin D deficiency. This study was done to validate a short dietary vitamin D questionnaire. Postmenopausal women (n=122), with a mean age of 63.9±7.8 years, completed a Brief Vitamin D Questionnaire (BVDQ), the Block Health History and Habits Questionnaire 1998 (BHHHQ98), a 3-day food record, and an evaluation of serum 25 hydroxyvitamin D (25[OH]D) levels. Data were analyzed using Pearson correlation coefficients, Wilcoxon signed ranks tests, and Bland-Altman analyses to compare the performance of the BVDQ to the BHHHQ98 and to the diet record. As asses...

The purpose of the study is to determine the type of fetal congenital abnormalities found among high risk pregnancies admitted in Fetomaternal Unit of Obs & Gynae Department in BSMMU. This is a cross sectional study done during the period July 2007 to June 2010. All the patients admitted with congenital abnormality in fetomaternal unit during this study period were included in this study. One hundred five cases had congenital abnormality of fetus among 1134 deliveries. Out of which 46.66% had CNS abnormalities and 19.04% had renal abnormalities. Out of CNS abnormalities Hydrocephalous (40.81%) was the most common, 31.42% patients were of age between 20-24 years, 69.52% patients had parity between 1-3, 35.37% had deliveries ?37weeks, 69.52% patients had vaginal deliveries, 82.89% patients were terminated by prostaglandins, 96.19% patients had no drug history other than intake of iron and calcium, 26.67% babies had birth weight between 1.1-1.5kg and 70.4% were of male babies. Advances in ultrasound technology have made possible the prenatal identification of an increasingly large number of fetal congenital malformations. Now fetal anatomical survey is performed routinely between 18 to 22 weeks. PMID:23134914

Joint inflammation in rheumatoid arthritis (RA) induces local periarticular osteoporosis. Generalised bone mineral density (BMD) decrease concerns approximately 50% of rheumatic patients. Both types of bone mass depletion can issue from cytokine-induced (TNF-alpha, IL-1, IL-6) osteoclasts' activation, osteoprotegerin and its ligand's (RANKL) function disorders, patients' immobilisation and glucocorticosteroid (GCS) intake, as well as from hormonal alterations in postmenopausal women, predominate among RA individuals. The aim of the study was to compare serum concentrations of marker of bone formation--serum aminoterminal propeptide of type I collagen (PINP), and bone resorption, carboxy (C) terminal telopeptide (Ctx), bone turnover markers in RA and osteoarthritis (OA) patients and in RA groups of different disease activity, different degree of joint damage and the history of GCS intake. A total of 50 RA female patients and 50 women with knee OA were included in the study. Blood for morphology and biochemistry laboratory tests was taken. Joint X-rays to establish OA and RA diagnosis and the degree of RA progression, as well as DEXA BMD measurements were performed. PINP and Ctx concentrations were assessed. In RA patients the number of swollen and painful joints, the duration of morning stiffness, visual analogue scale values and Waaler-Rose's test activity were recorded. The Disease Activity Index (DAS 28) was counted from the appropriate formula. No differences in bone turnover markers' concentrations were noted neither between RA and OA patients nor between the RA group when compared to the one without the history of GCS use. Bone turnover markers' concentrations in RA were proportional to the number of swollen and painful joints. However, no correlation was found between the markers' concentrations and RA activity assessed by DAS 28 or by laboratory means. Ctx concentrations were higher in patients at II degree joint damage according to Larsen and Dale's than at more advanced stages. Ctx concentrations decreased with the disease duration. Serum morphogenesis and resorption markers' concentrations change in course of RA indicating the decrease in bone metabolic activity with the disease duration and progression. High RA activity and severity correlate with increased markers' levels-the resorption one. The influence of GCS on bone metabolism in RA requires further study. PMID:19219607

Two dietary reporting methods were used to examine associations between macronutrient intake and subsequent cancer incidence in a cohort of Swedish women born between 1908 and 1930. 1361 subjects gave 23-h dietary recalls at their baseline examinations in 1968-1969, and 412 of them also provided detailed dietary histories. The cohort was followed up 19 years later by means of linkages with the National Cancer and Death Registries. Both dietary methods indicated that subjects who were ranked in the highest tertile of energy intake, relative to the lowest, were at significantly greater risk of developing cancer (all-site). Relative risks across energy intake tertiles were 1, 1.15 and 2.04, respectively, using the dietary history method and 1, 1.02 and 1.55 using the 24-h recall data. Examination of specific macronutrient energy sources indicated that dietary fat and carbohydrate are likely to have made the largest contribution to this association. However, after adjustment for total energy, none of the individual macronutrients was significantly associated with all-site cancer, by either dietary reporting method. When expressed as a percentage of total energy, low protein density of the diet was associated with increased cancer risk, by both dietary methods. However, this appeared to be a function of high energy intake rather than low protein intake. Simultaneous statistical adjustment for seven potential confounders of the association between energy intake and cancer was performed using both the 24-h recall and the dietary history data.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1623854

Objective We examined dietary fiber intake, food sources of dietary fiber, and relation of dietary fiber to body composition and metabolic parameters in college students with plausible dietary reports. Methods Students (18-24 y of age) provided data on anthropometry, fasting blood chemistries, and body composition (bioelectric impedance). Diet and physical activity were assessed with the Diet History Questionnaire and the International Physical Activity Questionnaire. Plausible dietary reporters were identified (+-1 SD cutoffs for reported energy intake as a percentage of predicted energy requirement). Multiple regression analyses were conducted with the total (n = 298) and plausible (n = 123) samples, adjusting for age, race, sex, smoking status, physical activity, energy intake, and fat-...

The role of the consumption of fat, animal protein and vitamins on breast-cancer risk was investigated in a hospital-based case-control study of 924 patients (409 cases and 515 controls) in Montpellier (France). A dietary history questionnaire, administered by interview, comprising 55 key food items as well as beverage consumption, and including food frequencies and portion sizes, was used to measure the intake of total fat and its constituents, animal protein, retinol, beta-carotene, vitamin E and alcohol consumption. The questionnaire also elicited information on relevant medical history and personal characteristics. All food items which showed significantly elevated odds ratio (high-fat cheese, desserts and chocolate and processed pork meat) in a multivariate analysis contained a high proportion of animal fat. This is reflected in the nutrient analysis, which showed a significant linear trend as well as an elevated odds ratio for the highest tertile of consumption of total fat [OR3 = 1.6 (1.1-2.2)], animal fat [OR3 = 1.6 (1.1-2.2)], saturated fat [OR3 = 1.9 (1.3-2.6)] and mono-unsaturated fat [OR3 = 1.7 (1.2-2.5)]. For post-menopausal women, there is a particularly strong association with saturated fat [OR3 = 3.3 (1.4-7.8)] in a multivariate analysis including all other significant nutrients. There is no evidence of an increase of risk with the intake of animal protein and no evidence of risk reduction with increased consumption of vegetables, beta-carotene or vitamin E. Along with some recent studies, our results give support to the hypothesis that dietary fat is a risk factor in breast carcinogenesis. PMID:2019449

Vitamin K is essential for the activity of ?-carboxyglutamate (Gla)-proteins including matrix Gla28 protein and osteocalcin; an inhibitor of vascular calcification and a bone matrix protein, respectively. Insufficient vitamin K intake leads to the production of non-carboxylated, inactive proteins and this could contribute to the high risk of vascular calcification in hemodialysis patients. To help resolve this, we measured vitamin K1 and K2 intake (4-day food record), and the vitamin K status in 40 hemodialysis patients. The intake was low in these patients (median 140??g/day), especially on days of dialysis and the weekend as compared to intakes reported in a reference population of healthy adults (mean K1 and K2 intake 200??g/day and 31??g/day, respe...

BACKGROUND: Inflammation has been established as a risk factor for cardiovascular diseases. The relationships of polyunsaturated fatty acids (PUFAs) and monounsaturated fatty acids to inflammation are still controversial in Western populations. The relationships are not clear in Japanese whose intake of seafood-based long-chain n-3 PUFAs is high.METHODS: We conducted a cross-sectional epidemiologic study in the Japanese population (1,556 men and 1,461 women aged 35-60). Serum high sensitivity C-reactive protein (CRP) was measured, and intakes of 7 specific fatty acids (% of energy) were evaluated by a validated self-administered dietary history questionnaire.RESULTS: CRP was significantly and inversely related to the intakes of oleic acid (p=0.008) and ?-linolenic acid (p=0.026) in women after adjustment for confounding factors. A multiple regression analysis showed that, especially in the middle tertile of long-chain n-3 PUFAs (eicosapentaenoic acid and docosahexaenoic acid) intake, CRP was inversely related to the intake of oleic acid and linoleic acid in both sexes and to the intake of ?-linolenic acid in women.CONCLUSION: Intakes of oleic acid, linoleic acid, and ?-linolenic acid would reduce serum CRP, especially when the intake of long-chain n-3 PUFAs is at a moderate level in Japanese.J Epidemiol 2007; 17:86-92.   

Background Multislice computed tomography (MSCT) permits direct visualization of not only coronary artery stenosis but also the characteristics of plaques in patients with coronary artery disease (CAD). Also, because of its potential to be a novel risk factor for cardiovascular disease, interest in non-alcoholic fatty liver disease (NAFLD) is increasing. Methods and Results Participants comprised 298 consecutive patients who received MSCT to diagnose CAD. Patients with an alcohol intake exceeding 20 g/day or with a history of known liver disease were excluded from the study. Liver steatosis and 4 coronary artery findings, including remodeling lesions, lipid core plaques, calcified plaques and narrowing of lumen, were assessed. Liver steatosis was evaluated by computed tomography density of the liver and spleen. In the study, NAFLD was defined as having a liver and spleen (L:S) ratio of <1.1. The L:S ratios of patients with remodeling lesions or lipid core plaques were significantly lower than those without. NAFLD was related significantly to those findings, but there was no correlation between calcified plaques, narrowing of lumen and L:S ratios. Adjusted odds ratio of NAFLD for remodeling lesions was 2.41 (95% confidence interval (CI), 1.24-4.67; p=0.009), and those for lipid core lesions was 2.29 (95% CI, 1.15-4.56; p=0.018). Conclusion NAFLD is a novel risk factor for vulnerable plaques. (Circ J 2008; 72: 618 - 625)   

Chronic Obstructive Pulmonary Disease (COPD) is a public health problem worldwide. Increased energy and protein needs, decreased energy and protein intake are common in COPD patients. Adequate intake is essential to improve pulmonary function and immune system, prevention of weight loss and maintaining muscle mass and strength. Assessment of energy and protein intake and its relationship with pulmonary function in COPD patients was performed in this study. The study group included 63 COPD patients. For all subjects, evaluation of energy and protein intake by Food Frequency Questionnaire (FFQ) and 24-hour recall, spirometry for measuring pulmonary function and determining disease severity were performed. The subjects were divided into three groups based on disease severity according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages. Relationship between energy and protein intake with pulmonary function was assessed. Energy and protein intake were lower than the calculated energy and protein demand for all groups. Significant relationship was found between the amount of protein intake extrapolated from food frequency questionnaire with Forced Vital Capacity (FVC) (r=0.2, P=0.02) and Vital Capacity (VC) (r=0.3, P=0.008). The results of the study suggest that accurate evaluation of protein and energy intake and requirements should be included in the goals of medical treatment of COPD patients. PMID:21287476

Background : Low food intake is a frequent problem in undernourished hospital patients. Objective: To study whether a reorganization of a hospital catering system enabling patients to choose their evening meal individually, in combination with an increase in the energy density of the food, increases the energy and protein intake of the patients. Design: Observational study comparing the food intake before and twice after the implementation of the new system, the first time by specially trained staff and the second time by ordinary staff members, following training. The amount of food served, eaten and wasted was measured, and energy and protein intake calculated. Results: The quartile of patients with the lowest energy intake consumed on average 128 kJ per patient [(95% confidence interval (CI) 79-178 kJ] with the old system; with the new system they consumed 560 kJ per patient (95% CI 489-631 kJ) on the first occasion, and 1021 kJ per patient (95% CI 939-1104 kJ) on the second occasion. With the old system, the wastage was on average 276 g per patient (48% of the total amount produced) compared with 118 g per patient (30%) and 78 g (21%) on the two test occasions with the new system. Conclusions: Reorganization of a hospital catering system can increase energy and protein intake and reduce waste substantially.

Abstract in portuguese OBJETIVO: Apresentar e discutir o caráter flexível que emergiu nos relatos sobre consumo alimentar em estudo qualitativo para avaliar práticas alimentares de pessoas submetidas a tratamento dietético por serem hipertensas e o impacto da preocupação com a saúde nestas. Os relatos de consumo alimentar foram analisados como representações sociais e se discutiu as implicações destas em inquéritos dietéticos. MÉTODOS: Em visita domiciliar foram entrevistados 30 h (more) ipertensos, sendo 15 de baixa renda e 15 de classe média. Para obtenção de informações sobre consumo alimentar foram aplicados os métodos recordatório alimentar de 24 horas, associado à história dietética e a um questionário de freqüência alimentar, no contexto de uma entrevista em profundidade semi-estruturada. As entrevistas foram gravadas, transcritas e analisadas em seu conteúdo. RESULTADOS: Situadas entre o discurso e as práticas, as representações expressaram flutuações e contradições sobre o consumo alimentar. Tais representações foram agrupadas em categorias apresentadas como: irregularidade da presença do alimento e das compras; modo de consumo conforme o tipo de alimento; variação do número de comensais; indução das respostas provocada pela busca de informações precisas por parte do entrevistador; falta de memória do entrevistado; imprecisão e contrariedade de relatos sobre consumo alimentar; uso de noções quantitativas cujos valores de referência são particulares ao sujeito e presença de terceiros testemunhando a entrevista. A estratégia metodológica utilizada permitiu observar que há menos precisão nas informações sobre consumo alimentar do que o esperado, por serem estas representações sociais, ou seja, construções mentais da realidade. Os resultados também sugerem que a abordagem da alimentação de sujeitos submetidos à prescrição dietética por meio de inquéritos alimentares pode ser insuficiente para conhecer suas práticas alimentares. Abstract in english OBJECTIVE: The objective of this qualitative study was to present and discuss the flexible characteristics emerging from reports on food intake of patients submitted to dietary treatment for hypertension control and the impact of anxiety on their health. Food intake reports were analyzed as social representations and their implications in nutritional investigations were discussed. METHODS: Thirty hypertensive subjects were interviewed by means of home visits; 15 were low- (more) income and 15 were middle-class individuals. The 24-hour diet recall method was used to obtain information on food intake, in association with diet history and a questionnaire on meal frequency, in the context of semi-structured in-depth interviews which were taped, transcribed and had their content analyzed. RESULTS: Social representations situated between theory and practice expressed fluctuations and contradictions regarding food intake. Such representations were grouped in categories such as: irregularity in food ingestion and food purchasing; intake method in accordance with the type of food served; oscillation in the number of people eating together; answers induced by the interviewer in search of accurate answers; lack of memory of the interviewed; imprecision and divergent reports on food intake; use of quantitative parameters whose reference values are sensitive to the subject and the presence of third parties witnessing the interview. The methodological strategy employed allowed the observation that there is less precision in the information on food intake than expected, as a result of its being composed of social representations, that is to say, mental constructions of reality. The results also suggest that the food inquiry approach for subjects submitted to dietary prescription may be insufficient to investigate their eating habits.

Background:  A substantial proportion of patients have recurrence of vascular events despite daily intake of low-dose aspirin therapy. Therefore, different patients may require different aspirin dosages to achieve complete inhibition of platelet function. Objective:  The aim of this work was to measure the response to low-dose aspirin therapy (150?mg/day) among patients with unstable angina or non-ST-segment elevation myocardial infarction and to find out whether titrating aspirin dosage to 300?mg/day, would provide a better therapeutic response in the resistant cases. Moreover, we also aimed to study any association between aspirin non-responsiveness and atherothrombotic risk factors. Methods:  The antiplatelet effect of 150?mg/day aspirin was studied prospectively in 50 consecutive patients with unstable angina or non-ST-segment elevation myocardial infarction. Platelet aggregation was measured using optical platelet aggregometry and serum thromboxane B(2) level. Aspirin resistance was defined as collagen (1??g/mL) and adenosine diphosphate (ADP) (5??mol/L)-induced platelet aggregation of ?40% when compared with control values. Twenty healthy age- and sex-matched individuals were taken as a control group. All patients were subjected to complete medical history (risk factors, medications), thorough clinical examination, ECG, coronary angiography and laboratory investigations including: complete haemogram, coagulation, kidney, liver and lipid profiles, fasting blood glucose and glycated haemoglobin (HbA(1C) ). Results:  Eleven of 50 patients (22%) were found to be aspirin resistant. A highly significant difference was found between the mean values of ADP, collagen-induced platelet aggregation percentage and thromboxane B(2) level after aspirin 150 mg/day when compared with the corresponding mean values after aspirin 300?mg/day among the resistant patients (66?±?7·01%, 62?±?4·34% and 620?± 64·58?pg/mL, respectively, vs. 26·87?±?2·85%, 16·5 ± 3·8% and 77?±?11·3?pg/mL) indicating enhanced response to aspirin after escalating the dose. The presence of atherothrombotic risk factors (hypertension, smoking, family history of ischaemic heart disease and previous MI) were not statistically different between aspirin-resistant and aspirin-sensitive patients. However, there was a highly significant difference between the aspirin sensitive and the resistant patients regarding the other risk factors (diabetes mellitus and dyslipidaemia) (P?patients when compared to 150?mg/day. There was a significant association between aspirin resistance and atherothrombotic risk factors (diabetes, hyperlipidaemia and obesity). PMID:23121257

OBJECTIVE: To assess the rates and explore predictors of microscopic gut inflammation in a cohort of patients with axial and peripheral spondyloarthritis (SpA). METHODS: Ileocolonoscopy was performed in 65 patients with axial and peripheral SpA from the Gent Inflammatory Arthritis and spoNdylitis cohorT. Histopathological analysis and scoring were performed by an experienced pathologist. RESULTS: Overall, 46.2% of the patients with SpA showed microscopic gut inflammation. In axial SpA, the following parameters were independently associated with gut involvement: male sex (OR=8.9, p=0.035); high disease activity measured by the Bath Ankylosing Spondylitis Disease Activity Index (OR=2.05, p=0.032); restricted spinal mobility measured by the Bath Ankylosing Spondylitis Metrology Index (OR=1.94, p=0.009); and younger age (OR=0.85, p=0.013). No clear association was found for human leucocyte antigen-B27 status, presence of peripheral arthritis, enthesitis, uveitis, psoriasis, intake of non-steroidal anti-in?ammatory drugs and family history of SpA. The prevalence of gut inflammation in non-radiographic axial SpA and ankylosing spondylitis was comparable. CONCLUSIONS: The prevalence of microscopic gut inflammation in SpA remains unaltered over time. Younger age (shorter symptom duration), progressive disease, male sex and higher disease activity are independently associated with microscopic gut inflammation in axial SpA. PMID:23139267

BACKGROUND: Moderate alcohol consumption may reduce cardiovascular events, but little is known about its effect on atrial fibrillation in people at high risk of such events. We examined the association between moderate alcohol consumption and the risk of incident atrial fibrillation among older adults with existing cardiovascular disease or diabetes. METHODS: We analyzed data for 30 433 adults who participated in 2 large antihypertensive drug treatment trials and who had no atrial fibrillation at baseline. The patients were 55 years or older and had a history of cardiovascular disease or diabetes with end-organ damage. We classified levels of alcohol consumption according to median cut-off values for low, moderate and high intake based on guidelines used in various countries, and we defined binge drinking as more than 5 drinks a day. The primary outcome measure was incident atrial fibrillation. RESULTS: A total of 2093 patients had incident atrial fibrillation. The age- and sex-standardized incidence rate per 1000 person-years was 14.5 among those with a low level of alcohol consumption, 17.3 among those with a moderate level and 20.8 among those with a high level. Compared with participants who had a low level of consumption, those with higher levels had an increased risk of incident atrial fibrillation (adjusted hazard ratio [HR] 1.14, 95% confidence interval [CI] 1.04-1.26, for moderate consumption; 1.32, 95% CI 0.97-1.80, for high consumption). Results were similar after we excluded binge drinkers. Among those with moderate alcohol consumption, binge drinkers had an increased risk of atrial fibrillation compared with non-binge drinkers (adjusted HR 1.29, 95% CI 1.02-1.62). INTERPRETATION: Moderate to high alcohol intake was associated with an increased incidence of atrial fibrillation among people aged 55 or older with cardiovascular disease or diabetes. Among moderate drinkers, the effect of binge drinking on the risk of atrial fibrillation was similar to that of habitual heavy drinking. PMID:23027910

Our objective was to examine the effect of nutritional intake and lifestyle factors on bone mass in postmenopausal Saudi women. A total of 122 apparently healthy postmenopausal Saudi women were recruited from the Center of Excellence for Osteoporosis Research in Jeddah. A questionnaire on lifestyle habits and dietary intake was administered to all participants. Anthropometric and bone mineral density (BMD) values were measured. Fasting blood samples were taken to measure concentrations of bone-related parameters and hormones. Most of the sample population was found to be vitamin D deficient with a serum vitamin D level below 50 nmol/l. Those participants with normal BMD values had significantly lower serum vitamin D levels than osteopenic individuals (P vitamin D intake level below the estimated average requirements. Only BMD of the femoral neck showed significant correlations with serum vitamin D level and dietary cholesterol intake. After adjustment for confounding variables; serum vitamin D levels were significantly correlated with cholesterol intake. Dietary calcium intake was significantly correlated with intake of protein and fiber whereas dietary vitamin D intake was significantly correlated with intake level of total fat, all fatty acids, cholesterol, and fiber. Our findings reveal the important role of dietary vitamin D and calcium in osteopenic patients and the likely requirement for supplementation of these nutrients in the Saudi population. PMID:21594583

Background:- The acute locomotor effects of voluntary ethanol (EtOH) intake in mice (stimulation/sedation) might be important behavioral indicators of an animals- propensity to engage in EtOH consumption and/or EtOH seeking behaviors. Using a binge-like EtOH intake model dubbed -Drinking-in-the-Dark (DID),- we recently observed home cage locomotor stimulation in C57BL/6J mice during an acute EtOH intake session, but acute home cage locomotor sedation following repeated EtOH exposures. To determine the role of novelty and/or EtOH history on these previously described locomotor effects, and to determine the relationship between these variables on locomotor activity immediately following DID intake, we conducted 2 separate experiments. Methods:- In experiment 1, mice were given access to eith...

Background Whether soy food consumption may protect against coronary heart disease (CHD) remains controversial. No previous study has used biomarkers of soy intake in assessing the relationship between soy consumption and CHD. Biomarkers that reflect both intake and metabolism may be more informative than self-reports of dietary intake. Methods We examined associations of urinary isoflavonoids, a biomarker of soy or soy isoflavone intake, with risk of CHD in a case-control study nested within two prospective cohort studies of Chinese adults in Shanghai. Cases were defined as subjects with no history of CHD at baseline who developed incident CHD during follow-up. Control subjects were randomly selected from those who remained free of CHD and matched to cases by sex, age, date and time of sa...

Up to 50% of uremic patients, including those treated with peritoneal dialysis (PD), suffer from protein and energy malnutrition (PEM). Malnutrition is strongly associated with an increased morbidity and mortality, in particular from cardiovascular diseases. Inflammation, low nutrient intake...

Background - The purpose of this study was to explore the cross-cultural differences in the frequency of fish intake and in motivations for fish consumption between people from households with (CVD+) or without (CVD-) medical history of cardiovascular disease, using data obtained in five European co...

BACKGROUND: A self-administered dietary history questionnaire, especially developed for use in a large French prospective cohort study, was tested for accuracy of food intake measurement by comparing it to the average of 9-12 24-hour recalls. This questionnaire was structured according to the French...

Associations have been reported between suboptimal maternal vitamin E intake during pregnancy and childhood asthma. This pilot study conducted in 2008/2009 investigated the feasibility and acceptability of a food-based randomized controlled trial in pregnant women to optimize dietary vitamin E intake to 15 mg/day. A food-based intervention using "food exchanges" to individually optimize dietary vitamin E intake to 15 mg/day was developed and included in an advice booklet. Forty-three pregnant women with a personal/partner history of asthma were recruited at 12 weeks gestation and randomized to food-based intervention or a control group until 20 weeks gestation. A registered dietitian assessed the vitamin E intake of 22 women and provided tailored advice on food-based exchanges to optimize their intake to 15 mg/day. The 21 control women were not given dietary advice. The food-based intervention was completed by 19 women and increased mean vitamin E intake: food diary data, 7.13 mg/day (95% confidence interval: 5.63 to 18.6) to 17.4 mg/day (95% confidence interval: 14.4 to 20.5) (Pvitamin E intake during pregnancy. Additional work is required to determine whether this intervention, if sustained for the rest of pregnancy, reduces the likelihood of childhood asthma. The methodology used in the design of this novel food-based intervention could be transferred to other nutrients. PMID:22741171

The impact of patient education on dietary fiber intake, diabetes control, and serum lipids was examined in patients with non-insulin-dependent diabetes mellitus. Customary outpatient personnel and procedures were used to teach three diet plans: the American Diabetes Association (ADA) diet, the ADA diet modified to increase high-fiber, high-carbohydrate foods (IF), and the IF diet supplemented with oat bran (IFOB). A control group was instructed on foot care to provide teaching visits. Fifty-two patients were recruited from an outpatient clinic and studied over a 6-wk period. Subjects were of low socioeconomic status and had completed a mean of 8.3 yr of education. Patients instructed to increase their intake of high-fiber foods reported a doubling of fiber intake and tolerated the diets well. Increased fiber and carbohydrate intake and decreased fat intake were associated with reductions in fasting plasma glucose levels. Increased fiber intake was also associated with reductions in total serum cholesterol and high-density lipoprotein cholesterol levels. Changes in fiber, carbohydrate, and fat intake were unrelated to changes in weight, serum insulin levels, or hemoglobin A1c levels over the study period. PMID:2994971

We present 2 patients with central diabetes insipidus in the setting of acute myelogenous leukemia (AML). Both patients had months of polyuria and polydipsia compensated by increased fluid intake. Decreased oral intake in the setting of acute illness with continued polyuria led to the development of hypernatremia and the recognition of the underlying diabetes insipidus. Both patients responded well to treatment with desmopressin. Hematologic abnormalities in patients with a diagnosis of central diabetes insipidus should prompt clinicians to consider the possibility of a new AML diagnosis or a relapse in patients with known AML in remission.

The central nucleus of the amygdala (CeA) has been implicated as having a significant role in mediating alcohol-drinking behavior. Neuropeptide Y (NPY) has been investigated as a potential pharmacotherapeutic due to its ability to attenuate ethanol intake, particularly when administered into the CeA. Previous research suggests, though the evidence is somewhat conflicting, that the efficacy of NPY is contingent upon genetic background and/or prior history of ethanol dependence in rats. However, studies looking at the effects of NPY in nonselected animals lacking a history of ethanol dependence have two factors that could impact the interpretation of the results: ethanol history/selection AND relatively low baseline ethanol intakes as compared to ethanol-dependent and/or genetically selected...

Full text: The aim of this study was to examine the effect of two different hydration regimes on the following: (i) Quantitative bone to soft tissue uptake of {sup 99m}Tc-MDP. (ii) The estimated bladder radiation dose. The factors thought to affect the bone to soft tissue uptake ratio for bone-seeking radiopharmaceuticals are age, weight, sex, renal function and state of hydration. Ambulatory patients, presenting for a bone scan were recruited and randomly assigned to drink either 500 mL or 2000 mL of water between the time of injection of tracer and imaging. Clinical history, age and weight were recorded. Blood for serum creatinine was taken prior to tracer injection. A TLD radiation monitor was fitted in the midline above the pubic symphysis and removed at three hours. Patients were instructed to empty their bladders at half hourly intervals. A quantitative bone to soft tissue ratio was derived using regions of interest drawn over the mid femora and the soft tissues of the lateral aspect of the thigh on anterior and posterior images. An intake of either 500 or 2000 mL of fluid following tracer injection for a bone scan does not significantly affect either the bone to soft tissue ratio of tracer uptake or the estimated radiation dose to the bladder.

Nutrient intake patterns were analyzed in 23 patients with gut failure who were receiving home parenteral nutrition (HPN). All patients had stable weights without changes in intravenous calories or protein for 3 consecutive months. Our objectives were to assess oral intake of calories, carbohydrates, fat, and protein, to examine relationships between oral nutrient intakes and disease categories, and to compare oral and intravenous intakes to calculated resting energy expenditure (REE). Two patterns of oral nutrient intake were identified among the patients. Patients with short bowel syndrome, regardless of the underlying disease, consumed calories by mouth that clearly exceeded calculated resting energy expenditure (short bowel, non-Crohn's, 170% of REE; short bowel, Crohn's, 200 of REE); however, calories approximating the REE had to be given via HPN, suggesting that efficiency of absorption was at a very low level. Patients with diffuse gut diseases (radiation enteritis or pseudo-obstruction syndromes) had very low intakes of oral nutrients. The distribution of oral calories among carbohydrate, protein, and fat did not differ among the disease categories.

This case report describes a patient with manic and psychotic symptoms who had a history of neurocysticercosis and presented with an episode of hypertensive hydrocephalus in 2003. Despite her history, she was initially treated for primary psychiatric disease.

... more difficult for them to keep their normal temperature. Constipation or heavier menstrual periods can result from ... problems includes examining the patients’ medical history, as well as family history. Some thyroid problems run in ...

A high concentration of remnant-like particles (RLP) has shown to be an arteriosclerosis risk factor that strongly reflects disorders of chylomicron and VLDL metabolism in patients with hyperlipidemia. The purpose of this study was to determine the serum concentrations of RLP-cholesterol after intake of meals containing medium-chain triglycerides (MCT) or long-chain triglycerides (LCT) in 29 healthy men. Test meals were prepared by a nationally registered dietitian as a pilaf containing 10 g of MCT or LCT and commercial clear soup. Blood samples were collected at 0, 2, 3, 4, 6 and 8 h after intake of the test meals. The concentrations of serum triglyceride, chylomicrons, chylomicron-triglyceride, RLP-cholesterol, VLDL-cholesterol, and VLDL-triglyceride after intake of MCT were lower than those after intake of the same amount of LCT. Moreover, the areas under the time-concentration curves of triglyceride, chylomicrons and RLP-cholesterol after intake of MCT were significantly lower than those after intake of LCT. The increases in concentrations of serum insulin and total ketone bodies after intake of MCT were significantly greater than those after intake of LCT. These results suggest that MCT may reduce the risk of coronary arteriosclerotic disease by attenuating the postprandial increase of RLP that is closely correlated with arteriosclerosis.   

We aimed to determine the natural history of borderline increases in albuminuria in adolescents with insulin-dependent (Type 1) diabetes mellitus (IDDM) and factors which are associated with progression to persistent microalbuminura. Fifty-five normotensive adolescents with IDDM and intermittent microalbuminura (overnight albumin excretion ratte of 20-200 micrograms min-1 on one of three consecutive timed collections, n = 29) or borderline albuminura (mean overnight albumin excretion rate of 7.2-20 micrograms min-1 on one of three consecutive timed collections, n = 30) were followed prospectively at 3 monthly intervals. The endpoint was persistent microalbuminuria defined as a minimum of three of four consecutive overnight albumin excretion rates of greater than 20 micrograms min-1. One hundred and forty-two adolescents with IDDM and normoalbuminura were also followed prospectively. Fifteen of the 59 patients (25.4%) with intermittent (9/29) or borderline (6/30) albuminura progressed to persistent microalbuminura (progressors) over 28 (15-50) months [median (range)] in comparison with two of the 142 patients with normoalbuminuria at entry (relative risk = 12.6; p = 0.001). Progressors to persistent microalbuminura were pubertal and had higher systolic (p = 0.02) and diastolic (p = 0.02) blood pressure, and HbA1c (p = 0.004) than non-progressors. All patients remained normotensive. Glomerular filtration rate, apolipoproteins, dietary phosphorus, protein and sodium intakes, and prevalence of smoking did not differ between progressors and non-progressors. Total renin was higher in the diabetic patients without a difference between progressors and non-progressors. In conclusion there is a relatively high rate of progression to persistent microalbuminuria in pubertal adolescents with borderline increases in albuminura and duration greater than 3 years. These patients require attention to minimize associated factors of poor metabolic control and higher blood pressure in the development of incipient nephropathy. PMID:9300227

Stress-induced eating disorders cause significant health problems and are often co-morbid with mood disorders. Emotional feeding, particularly in women, may be important for the development of obesity and failed attempts to lose weight. However, prospective studies assessing the effect of chronic psychosocial stress on appetite in different dietary environments in females are lacking. The present study tested the hypothesis that chronic psychosocial stress would increase consumption of high caloric diet and this emotional feeding would persist even when a healthier diet was available. Socially housed female rhesus monkeys were studied to address whether subordination increases caloric intake when a high fat and sugar diet (HFSD) was available concurrently with a low fat, high fiber diet (LCD). Cortisol responsivity and food intake were quantified during this choice phase and when only the LCD was available. The order of diet condition was counterbalanced to assess whether a history of HFSD would affect appetite. All females preferred the HFSD but subordinates consumed significantly more calories during the choice phase. The increased calorie intake was maintained in subordinate monkeys even after withdrawal of the HFSD. Subordinate females demonstrated reduced glucocorticoid negative feedback, with post dexamethasone serum cortisol levels significantly predicting intake of the HFSD but not the LCD during the choice condition. The cortisol response to an acute stressor significantly predicted subsequent intake of a HFSD in all females. Continual exposure to the psychosocial stress of subordination in female monkeys results in excess caloric intake of foods that mimic a western dietary environment. In addition, this social stressor interacts with a history of HFSD intake to promote increased feeding even in a healthy dietary environment. PMID:22377541

The aim of the study was to assess the association between usual dietary nutrient intake and obesity in Korean type 2 diabetic patients. We examined 2,832 type 2 diabetic patients from the Korean National Diabetes Program cohort who completed dietary assessment and clinical evaluation in this cross-sectional study. In men, higher dietary fiber intake was associated with a lower odds of being obese (P(trend) = 0.003) and in women, higher protein intake was associated with a lower odds of being obese (P(trend) = 0.03) after adjustment for age, diabetes duration, HbA1c, alcohol drinking, income, education level, and calorie intake. In men, higher fiber intake was associated with lower odds of obesity after further adjustment for diastolic blood pressure, physical activity, and possible confounding nutritional intake and medication. The multivariable adjusted odds ratio for the highest quintile of fiber intake was 0.37 (P(trend) diabetic men, suggesting a role for dietary fiber in the management and prevention of obesity in type 2 diabetes (ClinicalTrials.gov: NCT 01212198). PMID:23091316

Although we previously observed significant associations between intakes of several foods and constipation, definition of constipation was completely based on subjective perception assessed by a quite simple and single question: do you often have constipation? In this study, we examined the associations between food intake and functional constipation as defined according to symptom-based criteria (Rome I criteria: straining, hard stools, incomplete evacuation, and infrequency of bowel movement). Subjects were 3,835 female Japanese dietetic students aged 18-20 y from 53 institutions in Japan. Dietary intake was estimated with a validated, self-administered diet history questionnaire. The prevalence of functional constipation was 26.2%. Dietary intakes of several foods were significantly associated with functional constipation. A multivariate adjusted odds ratio (95% confidence interval; p for trend) for women in the highest quintile of dietary intake compared with those in the lowest was 0.59 (0.46-0.75; <0.0001) for rice, 0.77 (0.61-0.97; 0.003) for pulses, 1.64 (1.30-2.08; <0.0001) for confectioneries, and 1.41 (1.11-1.78; 0.01) for bread. In conclusion, intake of rice and pulse was negatively and that of confectioneries and bread was positively associated with functional constipation among a population of young Japanese women, which was generally consistent with our previous study where constipation was assessed by a quite simple question.   

BACKGROUND & AIMS: It has been suggested that serving from a buffet system may increase food intake. This observational study estimates the energy intake in a representative group of patients admitted to a hospital, where the food is served from a buffet system. MATERIAL: One hundred and sixteen random patients were screened according to the NRS-2002 system and the energy requirements were calculated. The type of food ordered for the patients and the energy intake were determined. RESULT: Eighty had an NRS score of 0-2, i.e. not at nutritional risk and 36 a score > or = 3, i.e. at nutritional risk. Among patients with NRS score > or = 3 only 50% were ordered the correct menu. Only 50% of the patients had an energy intake < 75% of their requirements. In the group of patients, who took < 50% of energy requirement more than 90% came from the main courses and very little from snacks. CONCLUSION: In-patients at nutritional risk focus should be on ordering the correct type of food for the main courses and especially on increasing the intake from snacks.

Background: This study was designed to determine the prevalence of protein-energy wasting (PEW) and its various types in hemodialysis (HD) patients in Tehran, Iran. Methods: For this cross-sectional study, 291 HD patients were randomly selected. The nutritional status of the patients was determined by subjective global assessment (SGA) and their dietary intakes were assessed using a 4-day dietary recall. In addition, serum high-sensitive C-reactive protein (hs-CRP) was measured. Results: The prevalence of mild-to-moderate and severe PEW based on SGA was 60.5% and 1% in Tehran HD patients, respectively. The prevalence of various types of PEW in HD patients was 20.5% type I (inadequate energy or protein intake without inflammation), 65.5% type IIa (inadequate energy or protein intake with in...

Patients who drink too much have more complications after surgery. The aim of this thesis was to evaluate the evidence, possible mechanisms, and prevention of the increased postoperative morbidity in alcohol abusers, defined by a consumption of at least five drinks per day. The literature could be criticised for several methodological flaws. Nevertheless, the results are in agreement showing moderate to strong evidence of increased postoperative morbidity after surgical procedures on alcohol abusers. There is weak to moderate evidence of increased postoperative mortality, hospital stay, and re-operation. The personal and economic consequences are tremendous. The incidence of alcohol abusers undergoing surgery was 7% to 49%, according to gender and diagnosis. They have been identified by a self-reported alcohol intake, which implies the possibility of underestimation. Alcohol markers could be used for a more precise identification of alcohol abuse. However, the inability of the questionnaires to detect short-term changes in intake and abuse without dependence, the inconsistent predictive values of the biological markers, and the lack of evidence of an association to postoperative morbidity reduces their usefulness. A detailed alcohol history is therefore recommended. The pathophysiology may include alcohol-induced organ dysfunctions. We demonstrated that subclinical cardiac insufficiency, immune incompetence, and haemostatic imbalance were already present preoperatively. A relation between the various lesions remains to be investigated. The surgical stress response was greater in alcohol abusers, which may further compromise the already dysfunctioning organs, thus leading to the documented increase in postoperative morbidity. Withdrawal from alcohol reverses organic dysfunction in non-surgical patients. Haemostasis normalises after one to four weeks, cardiac function after one month, immune function after two months, and response to external stress after three months. Accordingly, our small randomised investigation has shown that one month of abstinence before surgery improves several organic dysfunctions and reduces postoperative morbidity. We have demonstrated that prevention before surgery is possible. The study has methodological flaws, so further studies are required before final recommendations can be given. However, in the meantime clinical guidelines for alcohol abusers undergoing surgery should include up-to-date patient information and four weeks of abstinence before surgery, in accordance with the evidence-based association, the potential prevention attained by preoperative abstinence, and the best clinical practice. Implementation should be monitored in the clinical databases. In future, all patients admitted to surgery should be offered a health promoting dialogue with the surgeon, anaesthesiologist, general practitioner, or other health professionals, which focuses on alcohol among other risk factors in relation to the operative treatment, diagnosis and prognosis. A beneficial effect attainable from thismulti-modal prevention and fast track surgery should be investigated among the alcohol abusers.

Abstract in spanish Un paciente varón de 57 años alcohólico ingresó en nuestro hospital por alteración del nivel de conciencia y polirradiculitis. En el estudio analítico aparecía acidosis metabólica, hipopotasemia e hipofosfatemia. La cetoacidosis alcohólica es frecuente en estos pacientes. Todos ellos se presentan con una historia de abuso del alcohol, con cese del consumo los días previos por la aparición de náuseas, vómitos y dolor abdominal. Los datos básicos de laboratori (more) o son: glucemia normal o baja, acidosis metabólica con anión GAP elevado, ausencia de alcohol en sangre y cetonuria. Los mayores peligros son la hipovolemia, hipopotasemia, hipoglucemia y acidosis. El abuso del alcohol puede provocar un amplio rango de trastornos electrolíticos y del equilibrio ácido-base, incluyendo hipofosfatemia, hipomagnesemia, hipocalcemia, hipopotasemia, acidosis metabólica y alcalosis respiratoria. El deterioro del nivel de conciencia puede observarse en relación con intoxicación etílica aguda, encefalopatía de Wernicke, síndrome de abstinencia, mielinolisis central pontina, encefalopatía hepática, hipoglucemia y trastornos electrolíticos. Abstract in english A 57-year-old man with chronic alcoholism was admitted to our hospital due to disturbance of consciousness and polyradiculitis. Laboratory examination revealed metabolic acidosis, hypokalemia and hypophosphataemia. Alcoholic ketoacidosis is a common disorder in alcoholic patients. All patients present with a history of heavy alcohol misuse, preceding a bout of particularly excesive intake, which had been terminated by nausea, vomiting and abdominal pain. The most importan (more) t laboratory results are: normal or low glucose level, metabolic acidosis with a raised anion GAP, low or absent blood alcohol level and urinary ketones. The greatest threats to patients are: hypovolemia, hypokaliemia, hypoglucemia and acidosis. Alcohol abuse may result in a wide range of electrolyte and acid-base disorders including hypophosphataemia, hypomagnesemia, hypocalcemia, hypokalemia, metabolic acidosis and respiratory alkalosis. Disturbance of consciousness in alcoholic patients is observed in several disorders, such drunkenness, Wernicke encephalopathy, alcohol withdrawal syndrome, central pontine myelinolysis, hepatic encephalopathy, hypoglucemia and electrolyte disorders.

A 24-h home urine collection was conducted to estimate accurate salt intake in hypertensive outpatients. Using 24-h urinary creatinine excretion as a criterion for success, urine samples were obtained from 534 hypertensive patients. The urinary salt excretion of hypertensive outpatients ranged widely from 1.5 to 23.4 g/day (mean value 9.7±3.9 g/day). Urinary salt excretion was higher in males than in females (10.6±4.0 vs. 9.2±3.7 g/day, p <0.01). Based on the questionnaires, the patients were divided into salt-conscious patients, or those who were careful to reduce their daily salt intake, and non-salt-conscious patients. It was found that urinary salt excretion was lower in the salt-conscious group than in the non-salt-conscious group (9.4±3.8 vs. 10.6±4.0 g/day, p <0.01), but that urinary salt excretion adjusted for body weight was not significantly different between the two groups (0.16±0.06 vs. 0.17±0.07 g/kg/day). Our results suggest that there was no obvious reduction in the actual salt intake in salt-conscious patients, suggesting the importance of monitoring salt intake by 24-h home urine collection and informing patients of their actual salt intake as a means of encouraging the achievement of salt restriction. (Hypertens Res 2004; 27: 243-246)   

To discover the earliest symptoms and signs of neurological Wilson's disease we analysed the case histories of 136 patients who were seen between 1955-87: patients with hepatic or presymptomatic Wilson's disease were excluded from this series. Thirty one patients (23%) gave a history of an episode o...

The authors examined the association between dietary potassium, calcium, and magnesium intakes and the incidence of stroke among 34,670 women 49-83 years of age in the Swedish Mammography Cohort who completed a food frequency questionnaire in 1997. The authors used Cox proportional hazards regression models to estimate relative risks and 95% confidence intervals. During a mean follow-up of 10.4 years (1998-2008), 1,680 stroke events were ascertained, including 1,310 cerebral infarctions, 154 intracerebral hemorrhages, 79 subarachnoid hemorrhages, and 137 unspecified strokes. There was no overall association between potassium, calcium, or magnesium intake and the risk of any stroke or cerebral infarction. However, among women with a history of hypertension, potassium intake was inversely as...

Objective: A single-center, observational study was performed to identify the predictors for oral intake 3months after onset in stroke patients with severe dysphagia. Methods: Of 4972 consecutive acute stroke patients, 723 could not eat orally on day 10. Three months after onset, a questionnaire was sent to all patients. Those who survived and replied to the questionnaire were divided into 2 groups, and the clinical factors that predicted their acquisition of oral intake were analyzed. Results: Of the 586 dysphagic patients who responded, 141 (24.2%) achieved oral intake after 3months. On logistic-regression model analysis, age 80years, hyperlipidemia, non-cardioembolic stroke, modified Rankin Scale score 0 before onset, and National Institutes of Health Stroke Scale (NIHSS) score were ind...

BACKGROUND: The relationship between alcohol consumption and increased risk of lung cancer is controversial. This study was set up to investigate the association between alcohol consumption and death from lung cancer in a large Japanese cohort.METHODS: The subjects comprised 28,536 males, aged 40-79 years, living throughout Japan. During 268,464 person-years of follow-up, 377 lung cancer deaths were recorded. The hazard ratio (HR) of alcohol consumption for lung cancer mortality was calculated using the Cox proportional hazards model after adjustment for age, smoking and family history of lung cancer.RESULTS: There was no association between increased mortality from lung cancer and alcohol consumption among current drinkers. Compared with subjects who had never drunk alcohol, the HRs (95% confidence interval [CI]) of death from lung cancer for light (consuming <25.0 g ethanol per day), moderate (25.0-49.9 g per day) and heavy (? 50 g per day) drinkers were 0.81 (95% CI=0.61-1.07), 0.82 (0.61-1.11) and 0.97 (0.66-1.43), respectively. Further adjustment for fruit and vegetable intake did not change the results, and there was no change in HR materially after excluding those patients who died during the first 5 years of follow-up.CONCLUSIONS: These findings indicate that alcohol consumption was not associated with increased lung cancer mortality in this population of Japanese men.J Epidemiol 2006; 16: 49-56.   

A case of carotinaemia in a patient with excessive beta-carotene food-intake, diabetes mellitus and physiological amenorrhea is reported. The patient developed yellow discolouration in the palms and the soles of her feet. Blood samples showed a significantly increased lever of serum beta-carotene, but normal vitamine A value and liver enzymes. The patient reported an excessive intake of carrots (approximately 1 kg per day). The status of physiological amenorrhoea and dysregulated diabetes mellitus may have deteriorated the yellow discolouration of the skin. Udgivelsesdato: 2009-Jan-26

Association of intake of trans fatty acids in the 2nd trimester of pregnancy with risk of preeclampsia was studied by following 67 186 pregnancies of women participating in the Danish National Birth Cohort between 1998 and 2003. Diet was assessed with a food frequency questionnaire at gestation wk 25; preeclampsia diagnosis was obtained by linkage with the Danish National Patient Registry. 1804 cases of preeclampsia and 402 cases of severe preeclampsia were identified in the cohort. Intake of trans fats decreased during the study period as a consequence of reduction in industrial trans fat intake. Intake of trans fats in the 2nd trimester was unrelated to risk of preeclampsia or severe preeclampsia. Relative risk (95% confidence interval; P, trend) of preeclampsia and severe preeclampsia comparing top to bottom quintiles of trans fat intake were 0.95 (0.81; 1.11, 0.33) and 1.07 (0.78; 1.48, 0.92), respectively. It is concluded that 2nd trimester intake of trans fats is unrelated to risk of preeclampsia withinthe intake range observed in a period of gradual reduction of industrial trans fats from the Danish food supply.

Purpose: To identify the likelihood of family history as a risk factor for the presence and severity of primary angle closure (PAC) and primary open angle glaucoma (POAG) in a Chinese population. Methods: All participants were asked to complete a questionnaire and undergo a comprehensive eye examination. Past history of hypertension, diabetes mellitus, hyperopia, high myopia, and family history of glaucoma were recorded. For those patients with a family history of glaucoma, the relationship between the patient and the affected relatives has been specified. Results: A total of 332 PAC patients, 228 POAG patients and 193 controls were included. Of the 332 PAC patients, 83 (25.00%) had glaucoma family history. Characteristic-adjusted odds ratio (OR) of family history for PAC was 4.82 [95% con...

The objectives of this cross-sectional study were to estimate the prevalence and determine factors associated with anemia among pregnant women in rural Jordan. A cohort of 700 pregnant women from a National Health Service hospital and ten health centers completed a questionnaire. Of the total, 243 (34.7%) had anemia. The prevalence was the highest for women in their 3rd trimester (42.5%) compared to those in 2nd trimester (32.7%) and 1st trimester (18.9%). Gestational age, body mass index, history of previous surgery, and multivitamin intake during pregnancy were significantly associated with anemia. Women in the 2nd and 3rd trimesters had higher odds of anemia (OR = 2.2 and 3.3, resp.). Underweight women had higher odds of anemia (OR = 2.9). History of previous surgery and multivitamin intake during pregnancy were associated with higher odds of anemia (OR = 1.6 and 1.9, resp.). PMID:1582956

Abstract in portuguese A ruptura ou fistulização de vasos linfáticos para o interior do sistema excretor urinário dá origem à quilúria, que tem na bancroftose a sua principal etiologia. Pode ser, raramente, também causada por neoplasia, malformação linfática, traumatismo abdominal, assim como outras doenças infecciosas como a tuberculose. Os autores propõem as diretrizes gerais para a condução do portador de "urina leitosa" em áreas endêmicas e não endêmicas de filariose banc (more) roftiana. Ressaltam a importância dos exames de triagem e de outros mais sofisticados para uma investigação etiológica a partir da realização de anamnese e de exame físico criteriosos. Enfatizam a necessidade de que a doença deve ser conduzida através de uma abordagem mais abrangente, que compreenda, além da médica, a assistência social e a nutricional. Na grande maioria dos casos, o controle da quilúria está basicamente fundamentado na educação e na adequação do paciente a uma dieta hipolipídica/hiperprotéica e rica em líquidos. Abstract in english The rupture or fistulization of lymph vessels into the urinary system, known as chyluria (milky urine), is caused mainly by bancroftian filariasis. On rare occasions chyluria may also be caused by neoplasia, lymphatic malformation, abdominal trauma, as well as other infectious diseases such as tuberculosis. The authors proposed general guidelines to manage patients suffering from milky urine in Bancroftian filariasis endemic and non-endemic areas. They emphasized the impo (more) rtance of a careful diagnostic process accomplished using screening procedures, evaluating a detailed history of illness and performing a careful physical examination, targeting on the most suitable diagnostic tools for each case. In addition, they emphasized the need to manage the patient from a broader perspective, which goes beyond the medical aspect, involving also social and nutritional contexts. In the great majority of cases, controlling chyluria is fundamentally based on patient education and adjustment to a low lipid, high protein diet in addition to increased fluid intake.

This study analyzed the effects of a single daily oral dose (900 mg) of gemfibrozil on fasting and postprandial Lipids in hyperlipidemic patients. In 13 patients with hypercholesterolemia or mixed hyperlipidemia, the intake of a single daily dose (900 mg) of gemfibrozil for 3 weeks reduced the plasm...

Untreated patients suffering from myelomatosis were allocated at random for treatment by the daily oral administration of either cyclophosphamide or melphalan: 141 received cyclophosphamide and 133 melphalan. The trial began on 1 October 1964 and the intake of patients continued until 31 July 1968. ...

Bolus calculators are effective tools in controlling blood glucose levels in patients treated with insulin. Diabetics is a new software devised for patients to facilitate and improve self-managing for prandial insulin dosing and for better controlling food intake. This device contains two integral p...

Majority of physicians are of the opinion that Ramadan fasting is acceptable for well-balanced type 2 patients conscious of their disease and compliant with their diet and drug intake. Fasting during Ramadan for patients with diabetes carries a risk of an assortment of complications. Islamic rules a...

Background. Previously published investigations suggest a positive effect of increased water intake on headache, but a randomised controlled trial has not been done. Objective. To investigate the effects of increased water intake on headache. Methods. Randomised controlled trial in primary care with two groups and a follow-up period of 3 months. Patients were included if they had at least two episodes of moderately intense headache or at least five mildly intense episodes per month and a total fluid intake of less than 2.5 l/day. Both groups received written instructions about stress reduction and sleep improvement strategies. The intervention group additionally received the instruction to increase the daily water intake by 1.5 l. The main outcome measures were Migraine-Specific Quality of...

Understanding patterns of shared and type-specific etiologies for colorectal polyps may provide insights into colorectal carcinogenesis. The authors present the first systematic comparison of risk factors by colorectal polyp type in a large colonoscopy-based case-control study of 3,764 polyp-free controls and 2,543 polyp patients, including 1,444 cases with adenomas only, 662 cases with hyperplastic polyps (HPPs) only, and 437 cases with synchronous HPPs and adenomas. Surveys were completed to obtain information on usual dietary intake and other lifestyle factors. Six lifestyle factors, including cigarette smoking, obesity, no regular use of nonsteroidal anti-inflammatory drugs, high intake of red meat, low intake of fiber, and low intake of calcium, were found to be independently associat...

Objective: To assess the degree to which a history of childhood sexual abuse (CSA) moderates the association between sexual functioning and sexual distress in women. Method: Women with (n=105, M age=33.71, 66.1% Caucasian) and without (n=71, M age=32.63, 74.7% Caucasian) a history of CSA taking part in a larger clinical trial completed self-report questionnaires at intake including the Sexual Satisfaction Scale for Women (SSS-W), the Female Sexual Function Index (FSFI), and the Trauma History Questionnaire (THQ). Results: Desire, arousal, lubrication, and orgasm interacted with sexual abuse status in predicting sexual distress such that sexual functioning was more weakly associated with distress for women with a history of CSA. This disconnect was more pronounced for women who were abused ...

The relation between coffee and alcohol intake and ovarian cancer risk was analyzed in a case-control study conducted in Italy between 1992 and 1999. Cases were 1,031 women, aged 18-79 years, with incident, histologically confirmed invasive epithelial ovarian cancer, and controls were 2,411 women, aged 17-79 years, admitted to the hospital for acute nonneoplastic non-hormone-related diseases. Coffee intake (mostly espresso and mocha) was not associated with ovarian cancer risk, with an odds ratio (OR) of 0.93 [95% confidence interval (CI) = 0.69-1.27] in drinkers of > or = 4 cups/day compared with drinkers of or = 36 g/day compared with never drinkers). No relationship was found with wine (OR = 1.03, 95% CI = 0.70-1.50 for > 39 g/day compared with never drinkers), beer, amari, grappa, and spirits. No significant heterogeneity was found for coffee or total alcohol intake across strata of age, education, parity, oral contraceptive use, family history of ovarian/breast cancer, body mass index, and calorie intake. This study, based on a large data set; provides no support for a causal association between invasive epithelial ovarian cancer risk and coffee and alcohol intake. PMID:11588899

OBJECTIVE: To investigate whether gender differences in tooth loss are influenced by caries risk and sources of dietary calcium intake. METHODS: This was a cohort study that included 432 Danish adults (30-60 y old) with information on dietary calcium intake in 1982 and 1983 and tooth loss from 1987 and 1988 through 1993 and 1994. Total calcium intake, estimated by a 7-d food record or a a diet history interview, was divided into dairy and non-dairy forms of calcium. RESULTS: In men, a 10-fold increase in dairy calcium intake was significantly associated with a decreased risk of tooth loss (incidence-rate ratio 0.32, 95% confidence interval 0.15-0.68) even after an adjustment for tooth count in 1987 and 1988, age, education, and civil status (model 1), smoking, alcohol consumption, sucrose intake, and use of vitamin and/or mineral supplements (model 2), time since last dental visit and the presence of oral dryness (model 3), and a high Lactobacillus count (model 4). In women, dairy calcium was not statistically associated with tooth loss in the crude and adjusted models (models 1 to 3). However, the association became highly significant once the Lactobacillus count was included in model 4 (incidence-rate ratio 0.25, 95% confidence interval 0.09-0.73). Non-dairy calcium was not associated with tooth loss in men and women in the fully adjusted models. CONCLUSION: Dietary calcium intake, particularly calcium from dairy products, seems to protect against loss of teeth in adult men and women. The previous gender differences found in the relation between calcium intake and tooth loss may be the result of differences in the caries risk between genders.

Purpose Hypertriglyceridemia (hyperTG) is common among intensive care unit (ICU) patients, but knowledge about hyperTG risk factors is scarce. The present study aims to identify risk factors favoring its development in patients requiring prolonged ICU treatment. Methods Prospective observational study in the medicosurgical ICU of a university teaching hospital. All consecutive patients staying ?4?days were enrolled. Potential risk factors were recorded: pathology, energy intake, amount and type of nutritional lipids, intake of propofol, glucose intake, laboratory parameters, and drugs. Triglyceride (TG) levels were assessed three times weekly. Statistics was based on two-way analysis of variance (ANOVA) and linear regression with potential risk factors. Results Out of 1,301 consecutive adm...

ContextTaste and smell (chemosensory) alterations are common and distressing among advanced cancer patients, but their specific nature is poorly described and seldom linked to dietary intake. Details of altered chemosensory perception may help to explain food intake behaviors. ObjectivesOur goal was to characterize chemosensory alterations and their relationship with dietary intake and quality of life (QOL). MethodsAdult advanced cancer patients (n=192) completed a chemosensory self-assessment questionnaire to characterize changes in their sense of smell and four basic tastes (sweet, sour, salty, and bitter) since the onset of cancer, three-day food record, and QOL questionnaire. ResultsPatients experienced either no alteration in any basic tastes and sense of smell sensations (26% of pati...

Abstract in spanish Efecto de un programa de rehabilitación cardíaca en la alimentación, peso corporal, perfil lipídico y ejercicio físico de pacientes con enfermedad coronaria. Justificación y objetivo: Los programas de rehabilitación cardíaca (PRC), constituyen el mejor tratamiento para el control de los factores de riesgo cardiovascular en pacientes con enfermedad coronaria. El objetivo del presente estudio fue determinar los efectos de un PRC en el perfil lipídico, índice de ma (more) sa corporal (IMC) y alimentación de éstos pacientes. Métodos: El estudio fue prospectivo. Al inicio y final del programa se realizaron evaluaciones antropométricas, bioquímicas, dietéticas y de la capacidad funcional. El programa consistió de intervenciones educativas al paciente y su familia, la práctica de ejercicio físico (tres veces / semana, durante doce semanas), sesiones de psicología (una vez / semana) y sesiones nutricionales (una vez al mes por siete meses). Resultados: Participaron 61 pacientes, 76% masculino, la edad promedio de la población fue 53±12 años. Al momento de sufrir el evento coronario, 60% suspendió el fumado, 19% era diabético, 59% hipertenso, 80% dislipidémico y 61% sedentario. Al finalizar se observaron mejoras en el IMC (-1,47%), relación cintura / cadera (-1,14%), HDL-C (+3,76%), TG (-2,2%), LDL-C (-7,0%), Colesterol total (-4,9%) y en la capacidad aeróbica (+193%). Se encontró un patrón alimentario que reflejó la orientación nutricional recibida, aumento en la ingesta de frutas y vegetales, modificaciones en el consumo de grasa saturada por insaturada y consumo de leche descremada. Se presentó una mejoría de la capacidad funcional, aumentaron el umbral de la angina y se negativizaron el 10,7% de las pruebas de esfuerzo. Conclusión: Los datos evidencian que los PRC constituyen una alternativa viable para mejorar la calidad de vida de los pacientes después de sufrir un infarto. Abstract in english Effect the Cardiac Rehabilitation Program on food patterns, body mass index, lipid profile and cardiovascular fitness in patients with coronary artery disease. Background: The Cardiac Rehabilitation Program, (CRP) has been proposed as the bast treatment for controlling the cardiovascular risk factors in patients with the coronary artery disease. The purpuse of this study was to determine the effect of CRP on lipid profile, body mass index and food intake patterns in a gro (more) up of individuals with coronary artery disease. Methods: Heigth, weigth, and body mass index, waist/hip ratio, fasting plasma lipids, food intake and estimated METS were assesed at baseline and after the completion of the CRD. This program consisted of exercise (three times a week), psychological(once a week) and nutrition seccions(once a month for a total of seven months)for patients and their families. Each session lasted aproximately 2 hours. A total of 61 individuals with recent history of myocardial infarction participated in the study. Results: After the CRP there were redutions of BMI (-1.47%), waist/hip ratio (-1.14%) triglyceride levels (-2.2%), LDL-cholesterol levels (-7.0%), total cholesterol levels (+3.73) and the aerobic capacity (+193). The food intake pattern reflected an increase in fruits and vegetables and reduction in the consumption of meat and high fat-diary products. Conclusions: Our results suggest that the CPR represents an excellent alternative for reductingthe cardiovascular risk factors in post- myocardical event patients.

Background: Our research goals were to assess the prevalence of malnutrition in children with cancer, observe malnutrition's effect on tolerance to chemotherapy, and establish malnutrition at onset as one of the prognostic factors in children with hematological malignancies.Methods: This prospective study examined children ages 1-15 years with a confirmed diagnosis of acute lymphoblastic leukemia (ALL) and non-Hodgkin lymphoma. Each child was subjected to a detailed history, anthropometric examination, and laboratory investigations. Based on the anthropometric measurements that used weight-for-age Z scores, we divided the children into 4 groups: group 1, without malnutrition; group 2, mild malnutrition; group 3, moderate malnutrition; and group 4, severe malnutrition. We analyzed data for each group regarding the behavior of blood indices, the quantum of hematological support, bone marrow remission status on day 28, adherence to protocol schedules, and complications in the first 4 months of intensive chemotherapy.Results: Of the 34 patients in the study (mean age, 7.1 years; male:female ratio, 1.6:1), 79% had deficient calorie intake and 74% had deficient protein intake. Packed cell requirements and complications were significantly higher in malnourished children, whereas the requirement for platelet transfusions was statistically insignificant. Also, 50%, 40%, 38%, and 44% of children in groups 1, 2, 3, and 4, respectively, completed chemotherapy within the specified time period. At the end of the induction phase, 92%, 60%, 87%, and 77% of the patients in groups 1, 2, 3, and 4, respectively, achieved bone marrow remission. No deaths occurred in group 1; 1 death each occurred in groups 3 and 4, and 2 in group 2. When these deaths were extrapolated to the weight/height ratio (acute malnutrition), we found that all occurred in children with malnutrition, a statistically significant result.Conclusions: Malnutrition is widely prevalent in children with ALL in India and has a significant bearing on the occurrence of life-threatening complications and short-term outcomes in these children. Malnutrition is also a significant factor influencing treatment planning and therapeutic decisions. PMID:23049455

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Summary Background- Moderate to severe psoriasis is associated with increased alcohol intake and excessive mortality from alcohol-related causes. Alcohol biomarkers provide an objective measure of alcohol consumption. Carbohydrate-deficient transferrin (CDT) is the single most sensitive and specific alcohol biomarker. Objectives- To assess alcohol consumption in a cohort of patients with moderate to severe psoriasis using standard alcohol screening questionnaires and biomarkers. We investigated whether there was an association between alcohol intake, anxiety, depression and disease severity. Methods- Consecutive patients with chronic plaque psoriasis were recruited and completed a range of anonymized assessments. Psoriasis severity, anxiety and depression, and the impact of psoriasis on qu...

A cross-sectional study to investigate regional cerebral blood flow (rCBF) in patients with chronic whiplash syndrome and chronic neck pain patients without previous history of trauma along with a healthy control group. Chronic neck pain is a common disorder and a history of cervical spine injury in...

Vitamin C has several well-established roles in physiology including synthesis of collagen, carnitine and epinephrine, absorption of dietary iron, and mobilization of storage iron for erythropoeisis. Loss of several of these functions explains the pathology of scurvy, where defective collagen synthesis and anemia are major symptoms. Vitamin C deficiency is very common in dialysis patients and may arise from dialytic vitamin C clearance, restricted intake of vitamin C-rich foods, and increased vitamin C catabolism in vivo from inflammation. In the dialysis population, greater vitamin C intake may be needed for optimal health. Relationships between intake, body distribution, inflammation, and dialytic losses are complex and need further study. Concern about vitamin C metabolism leading to accumulation of tissue oxalate has led to the recommendation that vitamin C intake equals, but not exceeds, the intake recommended for the general population. Vitamin C deficiency in dialysis patients may have clinical consequences; a study in Renal Research Institute clinics found an association with periodontal disease. Data also support a role for vitamin C in prevention of dialysis-related anemia. New research questions are proposed in this editorial, with a discussion of strategies to determine the optimal provision of vitamin C for CKD patients. PMID:23106569

Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used. It is well recognised that they may adversely cause damage throughout the gastrointestinal tract and aggravate pre-existing disease. Their side effects on the upper gastrointestinal tract can be assessed by various means; each study type has different clinical connotations. Short-term use (less than 14?days) demonstrates dose-dependent damage of prescribed NSAIDs; the damage is proportional to the acidity of the drugs and not seen with Cyclooxygenase-2 (COX-2) selective inhibitors that have a pKa over 7.0. There have not been any serious outcomes, such as bleeding or perforation in these studies, and Helicobacter pylori (HP) plays no role in this damage. Long-term (3?months or more) endoscopy studies in patients show ulcer rates from 15%-35% with the various NSAIDs, but serious outcomes are exceedingly rare. Epidemiological studies show an association between NSAID intake and serious events. Ibuprofen is consistently at the lower end of toxicity rankings, whereas ketorolac and azapropazone are the worst. The risk of bleeding is increased with advancing age, presence of HP, previous history of bleeding, anticoagulant use, etc. The mega-trials show that COX-2 selective agents halve the bleeding episodes, but NSAID-induced gastric bleeding is very rare usually, less than 1 in 200 subjects taking them for a year. Seventy percent of patients develop NSAID-enteropathy, which is associated with intestinal blood and protein loss and rarely strictures. Over-the-counter (OTC) use of ibuprofen and diclofenac is associated with symptomatic gastrointestinal side effects comparable with placebo. Ibuprofen is shown to be remarkably well tolerated at OTC doses in a number of studies. There are recent studies to suggest that OTC NSAIDs should be taken on a fasting stomach, not with food as commonly advocated. PMID:23163547

Abstract in portuguese INTRODUÇÃO: Na última década foram introduzidos os imunomoduladores para o tratamento da esclerose múltipla (EM) forma remitente-recorrente (RR). OBJETIVO: Complementar o relato anterior da experiência de centro brasileiro no acompanhamento dos pacientes em uso dos imunomoduladores. MÉTODO: 390 pacientes que faziam uso de imunomoduladores no Centro de Atendimento à Esclerose Múltipla (CATEM), foram subdivididos por tempo de uso em três grupos, avaliando-se as oc (more) orrências de: abandono, gravidez, conversão da forma RR para secundária progressiva (SP) e da aderência. RESULTADOS: No Grupo 1, foram observados abandono do uso de imunomoduladores em 98 pacientes (25%) e aderência de 292 casos (74%); no Grupo 2, interrupção da medicação, no total de 140 pacientes, 92 (31%) por conversão para a forma SP, 14 (5%) por gravidez e 34 (11%) por abandono, mantendo a aderência em 88% dos demais pacientes; no Grupo 3, conversão em 41 (26%) dos casos, gravidez em 3 (2%) e abandono em 42 (27%). A aderência se manteve em 72%. O índice de migração foi de quase um terço (31,57%), no grupo 3, tendo como principais causas: a falha terapêutica e efeitos colaterais realizando-se a migração do imunomodulador em 0,5-2,5 anos. CONCLUSÃO: A percentagem de abandono observada é compatível com os dados encontrados na literatura mundial. Abstract in english BACKGROUND: Since 1997, immunological modulators have been used for treatment of Relapsing Remitting Multiple Sclerosis (RRMS) in the Multiple Sclerosis Attendance and Treatment Center (CATEM) with significant alterations in this disease natural history. AIM: To add data on the experience of CATEM for the treatment of RRMS patients that had immunomodulators. METHOD: RRMS patients that received continuously immunomodulator drugs were evaluated on adherence, migration, with (more) drawal and progression rates. The patients were divided in three groups by the period of immunomodulators intake. RESULTS: There were registered in Group 1 withdrawal in 98 patients (25%) and adherence in 292 cases (74%); Group 2 interruption of therapy in 140 patients, 92 (31%) due to progression for PSMS, 14 (5%) for pregnancy, withdrawal in 34 (11%), adherence in 88%; Group 3 progression in 41 (26%), pregnancy in 3 (2%) withdrawal in 42 (27%) and adherence in 72%. The migration rate was about one third (31.57%) and the principal cause was therapeutic failure; the mean migrating time was 0.5-2.5 years in group 3. CONCLUSION: Immunomodulatory treatment for RRMS patients may have significant levels of failure and side effects; the adherence was compatible with the international literature.

OBJECTIVE: Amylin, cosecreted with insulin, has like glucagon-like peptide-1 (GLP-1) been reported to inhibit glucagon secretion, delay gastric emptying, and reduce appetite and food intake. We investigated whether the effects of GLP-1 on gastric emptying, appetite, and food intake are mediated directly or indirectly via release of amylin. DESIGN: Eleven C-peptide and amylin-negative patients with type 1 diabetes mellitus (T1DM) and 12 matched healthy controls participated in a placebo-controlled, randomized, single-blinded, crossover study. With glucose clamped between 6 and 9 mm, near-physiological infusions of GLP-1, human amylin, pramlintide, or saline were given for 270 min during and after a fixed meal. Gastric emptying was measured using paracetamol, appetite using visual analog scales, and food intake during a subsequent ad libitum meal (at 240 min). RESULTS: In T1DM, gastric emptying, food intake, and appetite were reduced equally during low GLP-1 and amylin infusion compared with the saline infusion (P < 0.05). The controls showed stronger suppression of gastric emptying (P < 0.0001) and food intake (P < 0.01) with GLP-1 compared to amylin. Postprandial glucagon responses were reduced in controls and T1DM during GLP-1 and amylin infusions (P < 0.05). Amylin and pramlintide infusion had similar effects. CONCLUSIONS: GLP-1 exerts its effect on gastric emptying, appetite, food intake, and glucagon secretion directly, although secretion of amylin may contribute to some of these effects in healthy control subjects.

Natural toxin poisoning often occurs when amateur who has no expert knowledge of food collects and cooks the wrong material. In many cases, the symptoms of natural toxin poisoning are mild and the patients recover from illness within a day. However, if the patients have respiratory or neurological symptoms after several hours of intake, the patients must go to hospital immediately. Mushroom poisoning is often reported and puffer fish poisoning is sometimes reported in Japan. PMID:22894079

SummaryBackground & aims We described dietary habits in a Spanish sample of COPD patients and assessed its adequacy according to dietary recommendations, which so far have never been published. Methods 275 patients hospitalized for the first time for a COPD exacerbation in Spain answered a 122-item food frequency questionnaire on their last 2 years dietary habits. A Spanish food composition table was used to estimate nutrient intake. Adequacy of dietary intakes was assessed using the Spanish Nutrition Society guidelines for the elderly. Results Mean(SD) age was 68(8)years, 93% males, 32% current smokers, and post-bronchodilator FEV1 53(16)% predicted. Mean(SD) body mass index was 28(5)kg/m2, with only 2% of subjects under 20kg/m2. Mean intake of meat, poultry and eggs was slightly higher (...

Introduction The aim of this study was to evaluate the effect of hemodialysis (HD) duration on food intake and nutritional markers in patients with chronic kidney disease (CKD). Methods Twenty CKD patients received maintenance HD over a 9-year period. At the beginning of the study (T0) and at 3-year intervals (T1, T2, and T3) during the 9-year follow-up, a nutritional survey using the 24-h recall and record method was repeated for 4 days, and the blood samples were drawn. The results from T0 were used as references. Nutritional status was assessed through food intake, nutritional markers (urea, uric acid, creatinine, cholesterol, total protein, and albumin), and anthropometric measurements (height, dry weight, and body mass index). Results HD duration was correlated with energy intake (r?...

Increased systemic inflammation and oxidative stress are well established as nontraditional key players in the pathogenesis of atherosclerosis and are also involved in the innate immunity dysregulation in hemodialysis (HD) patients. The study aim was to investigate the effect of 1-year intake of pomegranate juice, an antioxidant source, on oxidative stress, inflammation, and long-term clinical outcomes. A randomized placebo controlled double-blind trial was designed, enrolling 101 chronic HD patients to receive during each dialysis 100 cc of pomegranate juice, or matching placebo, three times a week for 1 year. The primary endpoints were levels of oxidative stress and inflammation biomarkers. Secondary endpoints were hospitalization due to infections and the progression of atherosclerotic process based on a composite of variables of the carotid arteries: intima media thickness (IMT), number, and structure of plaques. Pomegranate juice intake yielded a significant time response reduction in polymorphonuclear leukocyte priming, protein oxidation, lipid oxidation, and inflammation biomarkers levels. These beneficial effects were abolished 3 months postintervention. Pomegranate juice intake resulted in a significantly lower incidence rate of the second hospitalization due to infections. Furthermore, 25% of the patients in the pomegranate juice group had improvement and only 5% progression in the atherosclerotic process, while more than 50% of patients in the placebo group showed progression and none showed any improvement. Prolonged pomegranate juice intake improves nontraditional CV risk factors, attenuates the progression of the atherosclerotic process, strengthens the innate immunity, and thus reduces morbidity among HD patients. PMID:22609423

The aim of our studies included measurement of serum Zn level in CAPD patients with the subsequent evaluation of relations between serum Zn and markers of nutrition, dietary intake, markers of acute phase reaction, CAPD adequacy, nitrogen balance as well as routine clinical and laboratory data. The study was performed in 81 patients treated with CAPD for up to 3 years (12 3-month study periods). Mean serum Zn concentration was 12.2 +/- 1.8 mumol/l and was decreased in 16% of patients. Positive correlation was shown between serum Zn level and prealbumin, iron, transferrin saturation, haemoglobin, mean corpuscular haemoglobin concentration and dialysis duration. Negative correlation was shown between serum Zn level and patients age as well as daily influent and effluent volumes, what means that patients in age over 65 years and those using daily inflow or outflow dialysate volume greater than 12.7 and 12.9 I, respectively, are at risk of Zn deficiency. Dietary Zn intake (9.9 +/- 2.5 mg/day) was in 96% of patients lower than that recommended for CAPD patients. Relation between Zn intake and ferritin, total cholesterol and vitamin E in serum as well as HDL-/total cholesterol ratio was shown. Our results indicate that approx. 16% of CAPD patients need Zn supplementation. Serum Zn level in CAPD patients shows a beneficial effect on serum markers of iron metabolism, blood morphology indices, serum lipid profile and increased serum vitamin E level. PMID:12089889

PURPOSE: B vitamins and methionine have been postulated to have potential effects on carcinogenesis; however, findings from previous epidemiologic studies on B vitamins, methionine, and lung cancer risk are inconsistent. We investigated associations of dietary intakes of B vitamins (i.e., riboflavin, niacin, vitamin B6, folate, and vitamin B12) and methionine with lung cancer risk among female never smokers. METHODS: The Shanghai Women's Health Study, a population-based, prospective cohort study, included 74,941 women. During a median follow-up of 11.2 years, 428 incident lung cancer cases accrued among 71,267 women with no history of smoking or cancer at baseline. Baseline dietary intakes were derived from a validated, interviewer-administered food frequency questionnaire. Cancer incidence and vital status were ascertained through annual linkage to the Shanghai Cancer Registry and Shanghai Vital Statistics Registry databases and through biennial in-person follow-ups with participants. Adjusted hazard ratios (HR) and 95 % confidence intervals (CI) were calculated using Cox regression. RESULTS: Dietary riboflavin intake was inversely associated with lung cancer risk (HR = 0.62; 95 % CI = 0.43-0.89; p trend = 0.03 for the highest quartile compared with the lowest). A higher than median intake of methionine was associated with lower risk of lung cancer (HR = 0.78; 95 % CI = 0.60-0.99); however, there was no dose-response relation. Intakes of other B vitamins were not associated with lung cancer risk. CONCLUSIONS: Our study suggests that dietary riboflavin intake may be inversely associated with lung cancer risk among female never smokers, which warrants further investigation. PMID:23065072

BackgroundKnowledge regarding the association between dietary sodium intake and the incidence of masked hypertension is limited.MethodsA total of 193 Japanese type 2 diabetic outpatients who had been treated with antihypertensive agents and with office blood pressures <140/90 mm Hg were recruited. Masked hypertension was defined as having office blood pressure <140/90 mm Hg and 24-h mean ambulatory blood pressure ?130/80 mm Hg. The dietary sodium intake was estimated by measuring the 24-h urinary sodium excretion.ResultsMasked hypertension was found in 128 (66.3%) patients. An age- and sex-adjusted univariate logistic regression analysis showed that urinary albumin excretion, renin-angiotensin system inhibitor use, office systolic blood pressure, and amount of dietary sodium intake were significantly associated with masked hypertension. A multivariate logistic regression analysis also identified an older age, renin-angiotensin system inhibitor use, an office elevated systolic blood pressure, and high dietary sodium intake to be independently associated with masked hypertension. When compared with those who consumed a low salt diet (sodium <120 mEq/day), the odds ratio for the risk of exhibiting masked hypertension in patients who consumed a medium salt diet (sodium 120 to <200 mEq/day) or a high salt diet (sodium ?200 mEq/day) were 5.3 (P < 0.001) and 12.6 (P < 0.001), respectively.ConclusionsMasked hypertension is a common feature in type 2 diabetic patients being treated for hypertension. The observed association with sodium intake raised the hypothesis that excessive sodium intake may play a part in the genesis of masked hypertension in these patients.American Journal of Hypertension 2012; doi:10.1038/ajh.2012.102. PMID:22810841

A restrospective study correlating allergy histories and reactions to X-ray contrast media was performed with a study group containing 519 patients receiving intravenous and infusion cholangiograms and 827 patients receiving intravenous and infusion pyelograms. Reactions against X-ray contrast media were observed significantly more frequently among patients with a positive allergy history independent of the suspected allergy (p<0.001) in cholangiogram cases, p=0.01 in pyelogram cases. These results emphasize the importance of obtaining an allergy history prior to patient examination with X-ray contrast media.

Abstract Aim:- To investigate adherence to dietary treatment and quality of life (QoL) in patients with phenylketonuria (PKU). Methods:- In the setting of a tertiary paediatric hospital, 41 early-treated patients affected by PKU aged more than 3-years old were enrolled in a cross-sectional study. Three-days dietary assessment, QoL questionnaires for patients <18-years old (Child Health Questionnaire) and Short Form for adults were completed. Results:- Of 41 patients, 23 (56.1%) were considered adherent to the dietary prescriptions as their phenylalanine intake was less than prescribed. Phenylalanine intake was significantly in excess of prescribed if mothers had a lower level of education. Adherence was not correlated with age. Metabolic control was obtained in 41.5-51.2% of the patients d...

Iodine requirements are increased during pregnancy and lactation and adequate iodine intake is important for normal brain development of the fetus/newborn child. The aim of the present study was to evaluate the extent to which this increase in iodine requirement is met in pregnant women living in various regions of Denmark. One hundred and fifty-two healthy pregnant women admitted to five different Danish departments of obstetrics participated in the study. Iodine status was evaluated by measurement of iodine in spot urine at day five after delivery and by careful history of the intake of iodine containing vitamin/mineral tablets. Approximately one third of the women had received tablets containing iodine. In women who had not received iodine supplementation urinary iodine was low with a median value of 39.7 micrograms/g creatinine (Aalborg 28, Randers 33, Ringkøbing 34, Arhus 43 and Copenhagen 62 micrograms/g creatinine). These values are far below internationally recommended levels. The consequences remain to be evaluated and no firm recommendations can be given. It seems reasonable, however, to recommend a high intake of food containing iodine (e.g. milk products) during pregnancy and lactation. Since nearly all the women took some kind of vitamin/mineral supplementation it could be considered to advocate intake of vitamin/mineral tablets containing iodine. Udgivelsesdato: 1993-Jul

Stool energy losses and the sources of energy within the stool were determined in 20 healthy controls and 20 patients with cystic fibrosis while on their habitual pancreatic enzyme replacement treatment. Stool energy losses were equivalent to 3.5% of gross energy intake in healthy children (range 1....

OBJECTIVE--To assess the value of serum carbohydrate deficient transferrin as detected by isoelectric focusing on agarose as an indicator of alcohol abuse. DESIGN--Coded analysis of serum samples taken from patients with carefully defined alcohol intake both with and without liver disease. Compariso...

Abstract in english The present prospective study was carried out to determine dietary fiber and energy intake and nutritional status of children during the treatment of chronic constipation. Twenty-five patients aged 2 to 12 years with chronic constipation were submitted to clinical evaluation, assessment of dietary patterns, and anthropometry before and after 45 and 90 days of treatment. The treatment of chronic constipation included rectal disimpaction, ingestion of mineral oil and diet t (more) herapy. The standardized diet prescribed consisted of regular food without a fiber supplement and met the nutrient requirements according to the recommended daily allowance. The fiber content was 9.0 to 11.9 g for patients aged less than 6 years and 12.0 to 18.0 g for patients older than 6 years. Sixteen patients completed the 90-day follow-up and all presented clinical improvement. The anthropometric variables did not change, except midarm circumference and triceps skinfold thickness which were significantly increased. Statistically significant increases were also found in percent calorie intake adequacy in terms of recommended daily allowance (55.5 to 76.5% on day 45 and to 68.5% on day 90; P = 0.047). Percent adequacy of minimum recommended daily intake of dietary fiber (age + 5 g) increased during treatment (from 46.8 to 52.8% on day 45 and to 56.3% on day 90; P = 0.009). Food and dietary fiber intake and triceps skinfold thickness increased during follow-up. We conclude that the therapeutic program provided a good clinical outcome.

This study documents the development of alkalosis in patients returning to caloric intake after a period of starvation and investigates the mechanisms responsible for this metabolic alteration. We studied the acid-base status, bicarbonate reabsorption, acid excretion, and sodium metabolism during fa...

... huh. Things like needing anti-inflammatory medications, other diseases such as Crohn’s disease or other disposing factors where patients may need ... micronutrient intake. It is variable. There’s certain pre-genetic disposition to hair loss as well. So it’s ...

4 days ago ... Nutrition is critical for health both on Earth and on board the International Space Station. ... assessment of dietary intake using a Food Frequency Questionnaire. ... understand changes in folate, vitamin B6, and vitamin D status, and ... loss is potentially valuable for patients suffering from bone loss on Earth.

As an initial subdeficient status of zinc, considered as an essential antioxidant trace element, is frequent in burned patients, we aim to assess the effects of low zinc dietary intakes on burn-induced oxidative stress, in an animal model. After 8 weeks of conditioning diets containing 80 ppm (contr...

This study compared national statistics for consumption of alcohol and dietary intake with the numbers of cases of chronic pancreatitis as recorded in a 10% sample of all hospital discharges (Hospital In-Patient Enquiry) and with the annual number of deaths. Hospital discharges for chronic pancreati...

Purpose: Family history is associated with gliomas, but this association has not been established for benign brain tumors. Using information from newly diagnosed primary brain tumor patients, we describe patterns of family cancer histories in patients with benign brain tumors and compare those to patients with gliomas. Methods: Newly diagnosed primary brain tumor patients were identified as part of the Ohio Brain Tumor Study. Each patient was asked to participate in a telephone interview about personal medical history, family history of cancer, and other exposures. Information was available from 33 acoustic neuroma (65%), 78 meningioma (65%), 49 pituitary adenoma (73.1%), and 152 glioma patients (58.2%). The association between family history of cancer and each subtype was compared with gliomas using unconditional logistic regression models generating odds ratios (ORs) and 95% confidence intervals. Results: There was no significant difference in family history of cancer between patients with glioma and benign subtypes. Conclusion: The results suggest that benign brain tumor may have an association with family history of cancer. More studies are warranted to disentangle the potential genetic and/or environmental causes for these diseases. PMID:22649779

Abstract in english Background: obstructed defecation is one of the most common subtypes of constipation, and it is frequently responsive to biofeedback treatment. Aims: since a history of sexual and physical abuse may be present in patients with obstructed defecation, we assessed the incidence of abuse history in patients with obstructed defecation referred to a general gastroenterology practice, and whether such a history may lead to a different outcome of biofeedback training in these pat (more) ients. Patients and methods: one hundred and twenty-one patients (17 men, 104 women, age 53 ± 15 years) with obstructed defecation were studied by retrospective chart review. Their history of sexual, physical and psychological abuse was obtained by a standard interview, and biofeedback training was carried out by means of a three-balloon technique. Results: a history of sexual/physical or psychological abuse was present in 12.4% patients. Biofeedback training yielded a successful improvement of obstructed defecation in 93% patients without abuse and in 100% of patients with abuse; this difference was not statistically different (p = 0.53). Conclusions: the prevalence of sexual/physical or psychological abuse in a population of patients with obstructed defecation referred to a general gastroenterology practice is relatively low; such a history seems not to affect the outcome of biofeedback training in these patients.

Abstract in portuguese INTRODUÇÃO: Constipação na gravidez é sintoma comum, mas para seu diagnóstico são necessários dois ou mais sintomas persistentes, como ritmo intestinal mais lento, dificuldade para evacuar, fezes endurecidas ou sensação de evacuação incompleta. Existem múltiplos fatores envolvidos, hormonais, sedentarismo, ingestão de fibras ou líquidos, uso de medicamentos, etc. OBJETIVO DO ESTUDO: analisar a incidência de constipação em 41 gestantes sadias do Ambulató (more) rio de Obstetrícia da Santa Casa de São Paulo. MÉTODO: a pesquisa se fez através do preenchimento de um questionário sobre ritmo intestinal, hábitos de vida, sintomas digestivos antes e após a gravidez. RESULTADOS: observamos que constipação incidiu em 27,6% daquelas que não sofriam sintomas pregressos. CONCLUSÃO: a incidência de constipação na gestação é menor que o usualmente estimado, começa no início da gravidez, e devido ao baixo índice encontrado não há razão para uso indiscriminado de laxativos. Abstract in english BACKGROUND: constipation is a common problem during pregnancy, but for a definitive diagnosis, symptoms such as low motility, defecation difficulties, hard feces and incompletet evacuation should be evaluated. There are a number of factors involved, including hormones, physical activity, water and fiber intake, medication, etc. OBJECTIVE: the objective of the present study was to analyse the occurence of constipation in 41 normal pregnant women from the Ambulatory of Obst (more) etrics and Gynecology Department at Santa Casa Hospital in São Paulo. METHOD: the patients filled a questionnaire with questions related to the frequency of stools, personal habits, symptoms and any other related conditions, before and after pregnancy. RESULTS: the overall incidence of constipation was 27.6%, excluding the subjects with previous history. CONCLUSION: we concluded that the incidence of constipation is lower than expected and generally occurs since the beginning of pregnancy. There seems to be no reason for the prescription of laxatives in most cases in pregnancy.

Migraine can be a very disabling disorder. Thus, migraine sufferers must be fully evaluated. To assess the number of days with crisis and the number of days with anti-migraine drugs intake a diary must be used. Disability and quality of life can be evaluated with questionnaires as MIDAS, HIT-6 or MSQOL. Emotional distress can be assessed with HAD scale. If the number of acute-migraine drugs intake is regularly higher than 8 days per month behavioural dependence should be looked at. A complete evaluation allows us to correctly manage patients: modify crisis treatment, start preventive treatment and view the withdrawal of acute migraine drugs. PMID:18437950

A 33-year-old woman with anorexia nervosa was admitted because of severe malnutrition. Acute liver injury was observed soon after the beginning of oral intake. She was prohibited from eating for 10 days and treated with parenteral nutrition until liver dysfunction was improved. One week after resuming oral intake, she presented severe hypoglycemic coma along with acute exacerbation of hepatocytic injury. Clinical laboratory data suggest that insufficient gluconeogenesis in acute liver injury was involved in severe hypoglycemia. We should be careful of severe hypoglycemia in patients with anorexia nervosa after resuming oral ingestion when signs of liver damage are detected, although hypoglycemic coma is uncommon in anorexia nervosa.   

The present investigation utilized a prospective design to investigate associations between changes in self-reported avoidant and active coping occurring during residential treatment for posttraumatic stress disorder (PTSD) and PTSD symptom severity at treatment discharge. Participants were 636 military Veteran patients (91.4 % male; M age?=?51.7 years) admitted to a Veterans Affairs (VA) residential rehabilitation program for PTSD, between 2000 and 2008. Results indicated that increases in avoidant coping and decreases in active coping from treatment intake to discharge were simultaneously and incrementally predictive of total PTSD symptom severity at treatment discharge, after accounting for PTSD symptom severity at treatment intake. These findings hold particular relevance for treatment...

Abstract Background- Conventional insulin therapy requires patients with Type-1 diabetes to adhere to rigid dietary and insulin injection practices. Recent trends towards flexible intensive insulin therapy enable patients to match insulin to dietary intake and lifestyle; however, little work has examined patients- experiences of incorporating these practices into real-life contexts. This qualitative longitudinal study explored patients- experiences of using flexible intensive insulin therapy to help inform the development of effective long-term support. Methods- Semi-structured interviews were conducted with 30 adult patients with Type-1 diabetes following participation in a structured education programme on using flexible intensive insulin therapy, and 6 and 12-months post-course. Longitu...

Posaconazole is a broad-spectrum triazole antifungal available as an oral suspension. Pharmacokinetic data showed a high variability of plasma posaconazole concentrations (PPCs) in patients, suggesting a potential interest in drug monitoring. The aim of our prospective study was to measure the PPCs in prophylactically treated patients to evaluate the impact of different factors on these concentrations. In 40 patients treated prophylactically with posaconazole for acute myeloid leukemia or myelodysplastic syndrome between February 2009 and August 2010, PPCs were measured at day 7 of treatment and then twice weekly. Demographic data, clinical data (including gastrointestinal disorders, comedications, and treatment compliance), caloric and fat intake, and biological data were collected and evaluated. We obtained 275 measurements of PPCs, with a median of 430 ng/ml. PPCs were significantly lower in patients with mucositis (P < 0.001), nausea (P = 0.03), diarrhea (P = 0.03), or vomiting (P = 0.05). PPCs were higher in patients with a higher caloric intake (P = 0.02), while the proportion of fat intake had no influence on PPCs (P = 0.84). The concomitant use of proton pump inhibitors decreased the PPCs (P = 0.02), while the use of tacrolimus increased the PPC (P = 0.03). In the multivariate analysis, the factors influencing the PPCs independently were the concomitant use of tacrolimus (P < 0.001), the presence of mucositis (P = 0.01), and food intake (P = 0.02). Our study confirmed the high variability of posaconazole bioavailability and showed the significant influence of gastrointestinal disorders, food intake, and concomitant medication on the PPCs. However, the optimal PPCs still remain to be defined and correlated with clinical efficacy. PMID:23027198

OBJECTIVE: Heterocyclic amines (HAA) are animal carcinogens that are present in meat cooked at high temperature and in tobacco smoke. These compounds require activation by cytochrome P450 1A2 (CYP1A2) and N-acetyltransferase-2 (NAT2) before they can damage DNA. This study tested the hypotheses that well-done meat and cigarette smoking increase the risk of adenoma, the precursor to most colorectal cancers, especially in individuals with rapid CYP1A2 and rapid NAT2 activities. DESIGN: An endoscopy-based case-control study of adenoma was conducted among Caucasians, Japanese and native Hawaiians to test this hypothesis. The overall diet and consumption of well-done meat cooked by various high-temperature methods were assessed by interview in 1016 patients with a first adenoma and 1355 controls with a normal endoscopy. A caffeine test was used to assess CYP1A2 and NAT2 activities in 635 cases and 845 controls. Logistic regression was used to account for matching factors and potential confounders. RESULTS: Smoking was associated with an increased risk of adenoma. Weak non-significant elevated OR were observed for the main effects of HAA intakes or NAT2 activity. However, the combined effects of HAA intakes and NAT2 activity were statistically significant. Subjects in both the upper tertiles of NAT2 activity and HAA intake were at increased risk of adenoma compared with subjects in the lower tertiles of NAT2 activity and exposure (2-amino-3,4,8-dimethylimidazo[4,5-f]quinoxaline intake OR 1.70, 95% CI I 1.06 to 2.75; 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline intake OR 1.91, 95% CI 1.16 to 3.16; and 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine intake OR 2.14, 95% CI 1.31 to 3.49). CONCLUSION: The data suggest that rapid N-acetylators with high HAA intake may be at increased risk of adenoma. PMID:22628494

We examined the associations of intake of vegetables, legumes and fruit with all-cause and cause-specific mortality in a population with prevalent diabetes in Europe. A cohort of 10,449 participants with self-reported diabetes within the European Prospective Investigation into Cancer and Nutrition study was followed for a mean of 9 y. Intakes of vegetables, legumes, and fruit were assessed at baseline between 1992 and 2000 using validated country-specific questionnaires. A total of 1346 deaths occurred. Multivariate relative risks (RR) for all-cause mortality were estimated in Cox regression models and RR for cause-specific mortality were derived in a competing risk model. An increment in intake of total vegetables, legumes, and fruit of 80 g/d was associated with a RR of death from all causes of 0.94 [95% CI 0.90-0.98]. Analyzed separately, vegetables and legumes were associated with a significantly reduced risk, whereas nonsignificant inverse associations for fruit intake were observed. Cardiovascular disease (CVD) mortality and mortality due to non-CVD/non-cancer causes were significantly inversely associated with intake of total vegetables, legumes, and fruit (RR 0.88 [95% CI 0.81-0.95] and 0.90 [0.82-0.99], respectively) but not cancer mortality (1.08 [0.99-1.17]). Intake of vegetables, legumes, and fruit was associated with reduced risks of all-cause and CVD mortality in a diabetic population. The findings support the current state of evidence from general population studies that the protective potential of vegetable and fruit intake is larger for CVD than for cancer and suggest that diabetes patients may benefit from a diet high in vegetables and fruits. PMID:18356334

Metals are involved in several important functions in the nervous system. Zinc and iron are increased and copper is decreased in the substantia nigra in Parkinson's disease (PD). However, epidemiological evidence for the association of dietary intake of metals with the risk of PD is limited. We investigated the relationship between metal consumption and the risk of PD in Japan using data from a multicenter hospital-based case-control study. Included were 249 cases within 6years of onset of PD based on the UK PD Society Brain Bank clinical diagnostic criteria. Controls were 368 inpatients and outpatients without a neurodegenerative disease. Information on dietary factors was collected using a self-administered diet history questionnaire. Higher intake of iron, magnesium, and zinc was indepe...

Purpose B vitamins and methionine have been postulated to have potential effects on carcinogenesis; however, findings from previous epidemiologic studies on B vitamins, methionine, and lung cancer risk are inconsistent. We investigated associations of dietary intakes of B vitamins (i.e., riboflavin, niacin, vitamin B6, folate, and vitamin B12) and methionine with lung cancer risk among female never smokers. Methods The Shanghai Women?s Health Study, a population-based, prospective cohort study, included 74,941 women. During a median follow-up of 11.2?years, 428 incident lung cancer cases accrued among 71,267 women with no history of smoking or cancer at baseline. Baseline dietary intakes were derived from a validated, interviewer-administered food frequency questionnaire. Cancer incidence ...

ObjectiveTo examine racial/ethnic differences in diet and physical activity behaviors in ethnic minority New York City children. MethodsCross-sectional data from a community-based study of 486 6- to 8-year-old children were used. Race/ethnicity was derived using a caregiver's report of child's race and Hispanic ancestry. Dietary intake was obtained by 24-hour diet recalls using the Nutrition Data System for Research. Physical activity was assessed with pedometers and caregiver interviews. We compared diet and activity measures across racial/ethnic subgroups using chi-square and analysis of variance tests. Multivariate analyses adjusted for age, gender, body mass index, and caregiver education (with breastfeeding history and total energy intake included in diet models). ResultsParticipants ...

Purpose B vitamins and methionine have been postulated to have potential effects on carcinogenesis; however, findings from previous epidemiologic studies on B vitamins, methionine, and lung cancer risk are inconsistent. We investigated associations of dietary intakes of B vitamins (i.e., riboflavin, niacin, vitamin B6, folate, and vitamin B12) and methionine with lung cancer risk among female never smokers. Methods The Shanghai Women?s Health Study, a population-based, prospective cohort study, included 74,941 women. During a median follow-up of 11.2 years, 428 incident lung cancer cases accrued among 71,267 women with no history of smoking or cancer at baseline. Baseline dietary intakes were derived from a validated, interviewer-administered food frequency questionnaire. Cancer incidence ...

Objective:Epidemiologic evidence concerning the role of dietary glycemic index (GI) and glycemic load (GL) in obesity during childhood and adolescence is limited, particularly in non-Western populations. We examined the association between dietary GI and GL as well as dietary fiber intake and overweight status in Japanese children and adolescents.Subjects:This Japanese cross-sectional study included 15?974 children (6–11 years; 7956 boys and 8018 girls) and 8202 adolescents (12–15 years; 3944 boys and 4258 girls).Methods:Dietary intake was assessed using a self-administered diet history questionnaire for children and adolescents. Body mass index (BMI) was calculated from self-reported body weight and height. Overweight was defined according to the International Obesity Ta...

Peptides involved in the regulation of body composition are of interest in hemodialysis (HD) patients because protein wasting associated with high fat mass (FM) is present in these patients. Zinc-a2-glycoprotein (ZAG), a new adipokine, is involved in the regulation of lipid metabolism, adiposity, and energy balance. The purpose of this study was to evaluate ZAG levels and its relationship with body composition and dietary intake in HD patients. Forty-nine HD patients (28 men, 53.1 +- 12.5 years, and BMI 24.0 +- 4.3 kg/m2) were studied and compared with 20 healthy subjects (9 men, 49.5 +- 15.2 years, and BMI 25.6 +- 4.1 kg/m2). Plasma ZAG levels were measured using the ELISA methods and body composition was evaluated through anthropometric data. Dietary intake was assessed 3 days by 24-hour...

Aims Severe heart failure (HF) is often associated with cachexia that reverses post-heart transplantation (HTx) with frequent development of obesity. Ghrelin is a novel appetite-stimulating hormone. The aim was to determine the role of ghrelin in regulating appetite, food intake, and body composition in HF and post-HTx. Methods and results We measured serial ghrelin, hunger sensation, caloric intake, and body composition in 12 HF patients awaiting HTx, 12 patients 12.7 +- 8.6 months post-HTx, and 7 controls. Seven of 12 HF patients were followed for longitudinal analysis post-HTx. Body mass index was 23.1 +- 3.1 in HF and 31.5 +- 5.5 post-HTx (P < 0.001). Heart transplantation patients had gained 18.0 +- 7.7 kg since HTx. Ghrelin area under the curve between controlled meals (control: 186 ...

AbstractObjectives/Hypothesis: To analyze a single surgeon's experience with endoscopic CO2 laser and stapler repair of Zenker diverticulum (ZD) by comparing dysphagia and regurgitation outcomes. Study Design: Retrospective chart review of 148 patient charts. Methods: Medical records of all patients receiving endoscopic repair of ZD with either CO2 laser (61 patients) or stapler (67 patients) were reviewed. Additional data included demographics (age and sex), size (cm), preoperative and postoperative symptoms, need for revision, and complications. Symptoms of dysphagia were graded based on a modified Functional Oral Intake Scale 1 to 4 scale (1 = normal intake; 4 = severely limited/G-tube dependent). Regurgitation was also graded on a 1 to 4 scale (1 = no regurgitation; 4 = aspiration even...

The relation between coffee, decaffeinated coffee, and tea intake and renal cell carcinoma (RCC) risk was analyzed in a case-control study conducted in Italy between 1992 and 2004. Cases were 767 subjects with incident histologically confirmed RCC and controls were 1,534 patients in hospital for acute non neoplastic conditions. Odds ratios (OR) and 95% confidence intervals (CI) for RCC were computed by multiple logistic regression models, conditioned on study center, sex, and age. Coffee intake (mostly espresso and mocha) was not associated with RCC risk, with an OR of 1.02 (95% CI 0.73-1.43) in drinkers of > or = 4 cups/day compared with drinkers of or = 1 cup/day compared with nondrinkers). No significant heterogeneity was found for coffee intake across strata of age, education, body mass index, and consumption of sugar. This study, based on a large dataset, provides further evidence that coffee, decaffeinated coffee, and tea consumption are not related to RCC risk. PMID:19116877

Summary This study examined the relationship between the subjective food intake of 30 food types and their objective bite force to identify the key food items within the 30 food types to achieve a greater depth of masticatory function in Korean adults. A sample of 308 (112 males and 196 females) adults over the age of 20 (average age, 486) was selected among patients who visited four dental hospitals in Seoul, Korea. The subjective masticatory ability was evaluated through an interview with food intake ability questionnaires consisting of 30 food types ranging from hard to soft using a five-step Likert scale. The objective maximal bite force was measured using pressure-sensitive films. The relationship between the food intake ability and bite force was analysed and stratified according to ...

Obesity has received much attention worldwide in association with an increased risk of cardiovascular diseases, diabetes, and cancer. At present, bariatric surgery is the only effective treatment for obesity in which long-term weight loss is achieved in patients. By contrast, pharmacological interventions for obesity are usually followed by weight regain. Although the exact mechanisms of long-term weight loss following bariatric surgery are yet to be fully elucidated, several gut hormones have been implicated. Gut hormones play a critical role in relaying signals of nutritional and energy status from the gut to the central nervous system, in order to regulate food intake. Cholecystokinin, peptide YY, pancreatic polypeptide, glucagon-like peptide-1, and oxyntomodulin act through distinct yet synergistic mechanisms to suppress appetite, whereas ghrelin stimulates food intake. Here, we discuss the role of gut hormones in the regulation of food intake and body weight. PMID:21949903

Article Title and Bibliographic InformationAssociations between fluorosis of permanent incisors and fluoride intake from infant formula, other dietary sources and dentifrice during early childhood. Levy SM, Broffitt B, Marshall TA, Eichenberger-Gilmore JM, Warren JJ. J Am Dent Assoc 2010;141(10):1190-1201. ReviewerJayanth Kumar, DDS, MPH Purpose/QuestionTo describe associations between dental fluorosis and fluoride intakes, with an emphasis on intake from fluoride in infant formula Source of FundingNational Institute for Dental and Craniofacial Research grants RO1-DE09551 and RO1-DE12101 and National Center for Research Resources grant M01-RR00059 Type of Study/DesignCohort study Level of EvidenceLevel 2: Limited-quality, patient-oriented evidence Strength of Recommendation GradeNot applic...

The aim of this study was to evaluate the adequacy of family history taking in epithelial ovarian cancer (EOC) patients and to identify factors that determine adequacy. Furthermore, the validity of family history taking was assessed by comparison with self-administered questionnaires. Medical records of all 1,112 EOC patients registered by the nation-wide cancer registry and diagnosed in eleven Dutch hospitals between 1996 and 2006 were reviewed. Adequate family history taking was defined as a written notification of the presence or absence of relatives with breast or ovarian cancer. Factors that were correlated with family history taking were identified using univariable and multivariable logistic regression.?147 patients filled in a postal questionnaire. An adequate family history was ta...

Cystic fibrosis-related diabetes (CFRD) is a frequent complication of cystic fibrosis. We report the significant improvement of diabetes control and quality of life in a CFRD patient using the sensor-augmented insulin pump. The system gives the patient the highest degree of flexibility, which is required in CFRD since food intake and activity levels vary widely from day to day, depending on the rapid changes of health status. PMID:18275362

Abstract in portuguese FUNDAMENTO: As crianças com cardiopatia congênita geralmente são desnutridas e apresentam algum grau de comprometimento funcional e/ou estrutural dos orgãos. Existe, ainda, uma deficiência na ingestão de nutrientes, corroborada pelo controle hídrico, que limita o aporte nutricional de alguns cardiopatas. OBJETIVO: Avaliar o consumo alimentar de crianças com cardiopatia congênita internadas na Unidade de Pediatria Cardiológica de hospital-escola público. MÉTODO (more) S: O consumo de alimentos e nutrientes foi calculado pelo consumo alimentar de três dias (método direto de pesagem) e o cálculo das calorias e nutrientes foi feito pelo software Virtual Nutri. RESULTADOS: O consumo de calorias/kg peso, de proteínas diárias, de sódio e de vitamina A esteve dentro do recomendado (p Abstract in english BACKGROUND: Children with congenital heart disease are usually malnourished and present some degree of functional and/or structural impairment of organs. There is also deficiency in nutrient intake, due to the control of fluids required by some patients which restrains the nutrient intake of some cardiac children. OBJECTIVE: To assess the food intake of children with congenital heart disease hospitalized in the pediatric heart unit of a "Public Teaching Hospital". METHODS (more) : The intake of food and nutrients was calculated based on the food consumed during three days (direct weighting method) and the calories and nutrients were calculated using the Virtual Nutri software. RESULTS: The intake of calories per kilogram of body weight, of daily proteins, sodium and vitamin A was within the recommended levels (p

Excessive NaCl intake is associated with a variety of fibrosing diseases such as renal and cardiac fibrosis. This association has been attributed to increased blood pressure as the result of high NaCl intake. However, studies in patients with high NaCl intake and fibrosis reveal a connection between NaCl intake and fibrosis that is independent of blood pressure. We find that increasing the extracellular concentration of NaCl to levels that may occur in human blood after high-salt intake can potentiate, in serum-free culture conditions, the differentiation of freshly-isolated human monocytes into fibroblast-like cells called fibrocytes. NaCl affects the monocytes directly during their adhesion. Potassium chloride and sodium nitrate also potentiate fibrocyte differentiation. The plasma protein Serum Amyloid P (SAP) inhibits fibrocyte differentiation. High levels of extracellular NaCl change the SAP Hill coefficient from 1.7 to 0.8, and cause a four-fold increase in the concentration of SAP needed to inhibit fibrocyte differentiation by 95%. Together, our data suggest that NaCl potentiates fibrocyte differentiation. NaCl-increased fibrocyte differentiation may thus contribute to NaCl-increased renal and cardiac fibrosis. PMID:11222951

A 77-year-old caucasian man presented on March 2005 with important epigastric pain without any other significant history of gastritis. Patient refers a history of cutaneous Kaposi's Sarcoma (KS) treated since 1974 with surgical excision or oncovorin topical injection. He underwent endoscopic evaluat...

We investigated the association between nutrient biomarkers and dietary intake estimated using a brief self-administered dietary history questionnaire (BDHQ) for Japanese children and adolescents. Blood samples were collected from 398 subjects (5th graders of elementary school aged 10-11 y, and 2nd graders of secondary schools aged 13-14 y) randomly selected from among students in Shunan City, Japan, who were then required to answer two questionnaires. Spearman correlations were calculated between dietary intake and the corresponding biomarkers (serum carotenoids, tocopherols, and erythrocyte fatty acids). Correlations with ?-carotene and ?-cryptoxanthin were significant in the 13- and 14-y age group (r=0.220-0.333, p<0.030) and the 10- and 11-y age subgroup who answered the questionnaire with assistance (r=0.295-0.299, respectively, p=0.006). Consumption of green-yellow vegetables and fruits was significantly correlated with ?-carotene and ?-cryptoxanthin levels (r=0.205-0.341, p<0.047). In the 13- and 14-y age group, correlations with eicosapentaenoic and docosahexaenoic acids were between 0.215 and 0.473 (p<0.040). Total seafood intake was significantly correlated with marine n-3 polyunsaturated fatty acids (PUFAs; r=0.239-0.420, p<0.023). In the 10- and 11-y age subgroup who completed the questionnaire with assistance, seafood intake was significantly correlated with marine n-3 PUFAs (r=0.239-0.243, p<0.032). In conclusion, dietary intake assessed using the BDHQ reflects the corresponding biomarkers for 13- and 14-y-olds; however, when used for elementary school children, caution is necessary in interpreting the results.   

Objectives To (1) characterise a cohort of patients attending a major osteoporosis clinic in Ireland and (2) examine the prescribing of preventative therapies amongst these patients. Methods Data were taken from 2006?2007 on patients attending the Osteoporosis Clinic at St. James?s Hospital, Dublin. Information gathered included age, gender, fracture history, past medical and surgical history, co-morbidities, the results of the first DXA scans, anti-resorptive therapies along with other medications prescribed. Results Of all patients 87.6% were female and the mean age was 68?years (SD?=?14.31). In total 166 (74%) patients had osteoporosis, 40 (17.8%) had osteopenia and 18 patients (8%) had normal T-score values, 163 (72.7%) had a history of a fracture. Only 13.7% of the patients did not ha...

Background Dietary factors play an important role in glycemic control in diabetic patients. However, little is known about their effects among Chinese diabetic patients, whose diets are typically abundant in fiber and high in glycemic index (GI) values. Methodology/Principal Findings 934 patients with type 2 diabetes and 918 healthy volunteers from Pudong New Area, Shanghai, China, were interviewed during the period of Oct-Dec, 2006 to elicit demographic characteristics and lifestyle factors. Dietary habits were assessed using a validated food frequency questionnaire. Anthropometric measurements, bio-specimen collection and biochemical assays were conducted at the interview according to a standard protocol. In this population, diabetic patients consumed lower levels of energy and macronutrients but had higher levels of fasting plasma glucose (FPG), glycolated hemoglobin A1c (HbA1c), triglyceride and body mass index than healthy adults. While the average consumption levels of the nutrients among diabetic patients did not vary along duration of the disease, the average levels of FPG and HbA1c increased with increasing duration. Regardless of diabetes duration, HbA1c level was observed lower in patients having a higher fiber or lower GI intake. Compared with those with the lowest tertile intake of fiber, the adjusted odds ratios (ORs) for poor glycemic control reduced from 0.75 (95%CI: 0.54–1.06) to 0.51 (95%CI: 0.34–0.75) with increasing tertile intake (P for trend level. Increasing fiber intake may be an effective approach to improve glycemic control among Chinese diabetic patients. PMID:10749457

Purpose - The purpose of this paper is to assess the nutritional status of radiological technicians and to identify their nutritional and health problems. Design/methodology/approach - A total of 80 adult radiological technicians aged 33.47.9?yr were chosen from hospitals and clinical settings in Minufiya governorate, Egypt. Data about socioeconomic status, health history, food habits, food consumption pattern, and food intake were collected. Blood samples were collected for the determination of haemoglobin (Hb), red blood cells, packed cell volume (PCV), leukocytes, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and immunoglobulin. Findings - Radiological technicians in this study have shown some signs of diseases as manifested by shortening of breath (26.3 percent), he...

The relationship between alcohol consumption and health outcomes has a long history and has generated much research. Heavy drinking is detrimental to health; however, there is considerable and convincing evidence from both short-term biochemical experimental studies and observational studies of a beneficial association with certain health outcomes related to atherosclerotic processes. This beneficial association is most important for an average alcohol intake of one to two drinks per day. Important factors in determining the magnitude or direction of effects have been identified. Most criticisms based on methodological issues have been dismissed in recent years from an epidemiological point of view. However, important questions remain about the circumstances of such a beneficial associatio...

The authors have encountered four cases of oil aspiration pneumonia complicated by carcinoma. Each had a clear-cut history of chronic intake of an oily substance, radiographic changes, and histologically documented oil aspiration pneumonia. Lung cancer later appeared in the involved area. A small number of similar cases also have been reported. The implication is that oil aspiration pneumonitis may induce bronchogenic carcinoma, particularly either the alveolar cell or the squamous cell variety. The radiographic diagnosis of the malignant transformation is difficult, and consequently the prognosis is poor.

This investigation examined personal and environmental predictors of substance treatment outcomes in youth. A 424 adolescents (M=15.9 years, S.D.=1.3) completed comprehensive assessments, including substance use, environmental factors (e.g., family history, social supports), and person-centered variables (e.g., Axis I diagnosis, motivation, self-esteem), at study intake and throughout the year following inpatient treatment. Youth treatment outcomes were assessed by relapse status (abstaining, minor relapse, major relapse) and DSM-IV dependence symptoms at 1 year. Relapse status was predicted by demographic (age), environmental (social supports), and person-centered factors (diagnosis) while dependence symptoms were best predicted by substance use variables alone. Consideration of the gener...

doi: 10.1111/j.1741-2358.2012.00624.x Gingival overgrowth in partially edentulous ridges in an elderly female patient with epilepsy: a case report Background:- Drug-influenced gingival overgrowth is an unaesthetic overgrowth of gingiva principally associated with intake of drugs like phenytoin, cyclosporin A and nifedipine. Its occurrence in both dentate and edentulous regions of oral cavity is poorly understood. Objectives:- This report highlights clinical and histological description, aetiology and management of gingival overgrowth in a partially edentulous (non-denture wearer) 60-year-old female patient with epilepsy on phenytoin and phenobarbital drugs from past 7-years. Materials and methods:- Patient-s intraoral examination revealed lobulated and fibrotic consistency gingival overgro...

Opinion statement The treatment goals for patients with gastroparesis are to control symptoms; to correct fluid, electrolyte, and nutritional deficiencies; and to identify and treat the underlying cause of gastroparesis. For mild symptoms, dietary modifications and a low-dose antiemetic and/or prokinetic agent might provide satisfactory control of symptoms. Dietary treatments include decreasing the solid food component while increasing the liquid nutrient component of meals. Fat and fiber intake should be minimized. Metoclopramide, despite its potential for neurological side effects, remains a prokinetic treatment for symptomatic patients. In patients with diabetic gastroparesis, careful regulation of glycemic control may help to reduce symptoms. Medical management of patients with gastrop...

The objectives were: (1) to investigate potential environmental and occupational risk factors of acute myeloid leukemia (AML), and (2) to explore the relationships between risk factors and AML subtypes according to the World Health Organization (WHO) classification. The investigation was a hospital-based case-control study consisting of 722 newly diagnosed AML cases (August 2003 through June 2007) and 1444 individually gender-age-matched patient controls at 29 hospitals in Shanghai. A 17-page questionnaire was used to obtain information on demographics, medical history, family history, lifestyle risk factors, employment history, residential history, and occupational and non-occupational exposures. Certain occupations of interest triggered a second questionnaire, which was occupation-specif...

... history that patients will present with is typically complaints of numbness and tingling in the fingers, and ... up the undersurface of the forearm. Other common complaints are weakness of grip and decreased finger flexion. ...

Objectives { To discuss history of health care in Palestine { To discuss Cancer care in Palestine { Health care issues z Infrastructure z Patient care z Human resources December 2007 H. Saca-Hazboun Gaza Gaza West Bank West Bank Gaza population

Method: From 1997 through 2000, 100 male gonorrhoea patients were followed for a mean of 18 months (range 8–42 months). Diagnosis and follow up were made by a combination of history, physical examination, and the Gram stained smear.

disturbances of the gastrointestinal tract, etc., play a less frequent role. ... heart region, after physical exertion, or after an intestinal disorder. The case histories of ... pathogenesis of transitory auricular fibrillation in patients with ath- erosclerotic ...

To examine the diagnostic sensitivity and specificity of dopamine transporter SPECT imaging with a highly dopamine transporter selective radioligand. The study included consecutively enrolled, drug-naive patients with an average short history of parkinsonian motor symptoms, referred for diagnostic scanning.

Thoracic endometriosis is a rare form of extrapelvic endometriosis. These patients typically present with catamenial pneumothorax or hemoptysis. Adequate clinical history coupled with HRCT helps in early diagnosis and appropriate management of thoracic endometriosis.

Chemotherapy-induced nausea and vomiting (CINV) is associated with a significant deterioration in quality of life. The emetogenicity of the chemotherapeutic agents, repeated chemotherapy cycles, and patient characteristics (female gender, younger age, low alcohol consumption, history of motion sickn...

Periodontoid pseudotumor (PP) can be a severe and disabling disease. This disease process typically presents in elderly patients with a longstanding history of myelopathy. We reviewed four cases of PP in order to summarize the clinical and imaging features. (orig.)

In Taiwan, national health insurance coverage began in 1994, and the Bureau of National Health Insurance has issued health smart cards since 2004. In addition to tracking medical reimbursements, these smart cards store healthcare information, including electronic prescriptions, medical procedure and vaccination records, drug allergy histories, and information about a patient?s willingness to be an organ donor. We conducted this study 4 years after the smart cards had been introduced in order to review how drug allergy history is recorded using this system. Our results reveal that the drug allergy histories are incomplete in many cases, and the format used to record a patient?s drug allergy history is not consistent. We offer suggestions to promote the standardization of drug allergy histor...

... the ilium. We want to maintain those growing cells to try to prevent migration of the Dunn- ... data that we're looking at increasing death rates in these untreated natural history patients in infantile ...

...880.6315 Section 880.6315 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT...patient's command, and to record a history of the event for the health care...entitled âGuidance for Industry and Food and Drug Administration Staff;...

The case history is presented of a patient with pathologically proven dendriform pulmonary ossification and rare earth pneumoconiosis confirmed by analytical transmission electron microscopy. This is thought to be the first report of this association.

... the web from the beautiful, state-of-the-art Homestead Hospital, part of the Baptist Health South ... tell us about your patient, something about her history and the symptoms she was experiencing? Sure, this ...

... a good number now self-refer based on knowledge from the internet or other places where they ... about their smoking history, etc. What is the management for patients who are at risk? Based on ...

Summary Background: Although epilepsy affects most patients with tuberous sclerosis complex (TSC), little is known about the natural history of epilepsy in this genetic disease. Methods: A retrospective chart review of all patients with TSC seen between January 2002 and October 2008. Charts were reviewed for a history of infantile spasms (IS), seizure other than IS, refractory epilepsy, Lennox-Gastaut syndrome (LGS), anticonvulsant medication use, ages of seizure onset, last seizure, last clinic visit, clinical seizure phenotype(s), cognitive impairment, and genetic mutation. Results: Two hundred ninety-one patients were included. Among these patients, 37.8% had a history of IS; 85.2% had a history of seizure; 54.1% developed multiple seizure types, not including IS; 63.2% had seizure onse...

Introduction: Trauma is a major cause of paediatric morbidity and mortality, yet knowledge of fluid resuscitation is limited. Our objectives were to determine current practises in resuscitation volume (RV) administered to paediatric non-haemorrhagic (NH) blunt trauma patients and to identify fluid related complications. Methods: We examined data from 139 trauma patients 1-17years of age with an injury severity score >=12 resuscitated at a Trauma-designated Children's Hospital. Patients were separated into discreet groups based on ATLS age-dependent vital functions: toddler/preschooler (1-5years), school age (6-12years) and adolescent (13-17years). Results: The median RV (total fluid intake-maintenance fluid intake) in ml/kg over the first 24h from the time of trauma by age was: 24 (IQR=19-...

Brampton Civic is situated in a vibrant multicultural community in the outskirts of Toronto. Since inception in 1987, the program has grown to encompass a central intake, Out- patient services, intensive unit, inpatient services, and a day hospital, incorporating a preexisting out- patient community psychiatric clinic. Within this continuum of services, staff members use a multidisciplinary team approach to treat children and adolescents up to 17 years of age. For example, central intake provides the screening service for all referrals to the program. The out- patient service provides an initial psychiatric consultation and some limited follow-up. The intensive unit's role is to stabilize the acutely ill in a secure and supportive setting. Assessment initiation and determination of the nex...

Abstract in english A major concern about the increase of metabolic disorders rates associated with medication use to treat severe mental illnesses (SMI) exit. In fact, several studies suggested an association of body fat distribution with cardiovascular disease, diabetes, etc. On the other hand, psychotropic medications have come to play an increasingly central role in the treatment of psychiatric disorders and many patients consuming psychotropic drugs as medication tend to become obese an (more) d they are sensitive to the diseases mentioned above. In addition, it has been associated that a healthy and equilibrated food intake could help to prevent diseases. In this review we will address the effects of psychotropic medication intake and how this relates to obesity, risk of cardiovascular diseases of patients who suffer from severe mental illnesses. It will also evaluate the potential use of healthy diets and exercise to improve the well being of the patient.