Articles de revues : « Wasting Syndrome, diet therapy »

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Szeredi, Levente, et Csaba Szentirmai. « Gastric zygomycosis in a pig affected with postweaning multisystemic wasting syndrome — Case report ». Acta Veterinaria Hungarica 56, n^o 2 (1 juin 2008) : 207–13. http://dx.doi.org/10.1556/avet.56.2008.2.8.

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A postweaning pig died in spite of antibiotic therapy showing wasting in a small herd. Postweaning multisystemic wasting syndrome (PMWS) was diagnosed on the basis of gross pathological and histological lesions and the presence of moderate amounts of porcine circovirus 2 (PCV2) antigen in tissue samples. Mycotic gastritis caused by Zygomycetes spp. was found on round areas with a diameter of 1 to 3 cm in the glandular mucosa of the stomach. Moderate amount of PCV2 viral antigen was detected almost evently in the stomach and mostly in the macrophages. In addition, acute uraemia, revealed by an ammonia-like stink of the gastric mucosa and the presence of acute erosions on the glandular mucosa of the stomach, was observed as a consequence of PCV2-induced interstitial nephritis. Only PCV2 infection could be identified as a cause of secondary mycotic gastritis. The results further support the immunosuppressive ability of PCV2 infection in PMWS-affected pigs.

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Farrukh, Hina, Amina Mehrab et Abeera Khan. « Adrenal Insufficiency Presenting as Hypoglycemia & ; Hyponatremia in a Patient With Liver Cirrhosis ; Hepatoadrenal Syndrome ». Journal of the Endocrine Society 5, Supplement_1 (1 mai 2021) : A111. http://dx.doi.org/10.1210/jendso/bvab048.223.

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Abstract Hepatoadrenal syndrome is described as a progressive impairment in the adrenocortical reserve in advanced liver disease resulting in relative adrenal insufficiency (AI). This can present as critical hypoglycemia and hyponatremia as in the case described. 54 year old male with past medical history of hypothyroidism, pericardial effusion, liver cirrhosis and prior alcohol use disorder presented to the hospital with altered mental status. He felt lethargic and complained of recurrent diarrhea for a month. His blood sugar was 30 mg/dl (n=70–140 mg/dl) for which he received dextrose and his mentation improved. He was hypothermic with stable vitals otherwise. There was no skin hyperpigmentation. Labs demonstrated sodium of 123 mmol/L (n=136–145 mmol/L) and pancytopenia. TSH, ammonia, renal and hepatic functions were within normal limits except mildly elevated AST and total bilirubin. Total protein, albumin, HDL, Insulin and cortisol levels were low. Hepatitis panel was negative. CT Chest, abdomen and pelvis revealed massive abdominopelvic ascites, hepatic cirrhosis and splenomegaly. Adrenal glands appeared normal. Urine studies were consistent with salt-wasting nephropathy. Patient was started on intravenous fluids as well as dexamethasone. Diagnostic and therapeutic paracentesis was performed. Cosyntropin stimulation test revealed a baseline AM cortisol of 2.0 ug/dl (n=4.3–22.4 ug/dl), 30 min value of 4.0 ug/dl and 60 min value of 5.8 ug/dl (n=18-22ug/dl). Delta cortisol level was also low. Treatment with hydrocortisone was initiated until ACTH levels became available. To rule out sarcoidosis, ACE levels were obtained, which were normal. Dihydroxy 1,25 Vitamin D levels were low. ACTH returned as 21.7 pg/ml (n=7.2–63.3 pg/ml). 21 hydroxylase antibody was negative. MRI brain with IV contrast demonstrated no pituitary mass or abnormality. Blood cultures, body fluid cultures, AMA and ASMA were negative. Anti- tTG and Anti Gliadin antibodies were positive confirming celiac disease. Patient was started on gluten free diet which resolved his diarrhea. He responded well to steroids however, he remained intermittently confused which was thought to be related to hypoglycemic brain injury. Patient was converted to hydrocortisone PO 20 mg in AM and 10 mg in PM and advised to follow up outpatient with endocrinologist and gastroenterologist. Hepatoadrenal syndrome is an important differential to consider in patients with liver disease presenting with hypoglycemia and hyponatremia. It is a potentially life-threatening condition requiring immediate treatment and appropriate work up. The condition improves with corticosteroid replacement therapy. Reference: Anastasiadis SN, Giouleme OI, Germanidis GS, Vasiliadis TG. Relative adrenal insufficiency in cirrhotic patients. Clin Med Insights Gastroenterol. 2015;8:13–17. Published 2015 Mar 2. doi:10.4137/CGast.S18127

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Ogoina, Dimie, Reginald O. Obiako et Haruna M. Muktar. « HIV Wasting Syndrome in a Nigerian Failing Antiretroviral Therapy : A Case Report and Review of the Literature ». Case Reports in Medicine 2010 (2010) : 1–5. http://dx.doi.org/10.1155/2010/192060.

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The HIV wasting syndrome represented the face of HIV/AIDS before the advent of highly active antiretroviral therapy (HAART). Although the incidence of wasting has declined since the introduction of HAART, weight loss remains common in patients receiving HAART, especially in the setting of a failing HAART regimen. As we are not aware of any previous reports from Nigeria, we report a case of the classical wasting syndrome in a Nigerian female who had both virological and immunological HAART failure due to poor adherence. The influence of a failing HAART regimen, socioeconomic status, and other clinical variables in the wasting syndrome are discussed.

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Bakulin, I. G., E. B. Avalueva, L. S. Оrеshkо, S. I. Sitkin, M. A. Shevyakov, M. U. Serkova et E. A. Semenova. « Diet therapy for irritable bowel syndrome ». Terapevticheskii arkhiv 92, n^o 8 (3 septembre 2020) : 118–27. http://dx.doi.org/10.26442/00403660.2020.08.000759.

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The review provides present information on the pathogenesis of irritable bowel syndrome (IBS), the relationship of endogenous and exogenous factors with the development of IBS-symptoms, questions of diet therapy are discussed, diets traditionally prescribed in IBS treatment and diets, such as FODMAP and gluten-free diet, which are the most promising and have a positive effect on the symptoms of IBS.

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Balog, Denise L., Marcia E. Epstein et Maria I. Amodio-Groton. « HIV Wasting Syndrome : Treatment Update ». Annals of Pharmacotherapy 32, n^o 4 (avril 1998) : 446–58. http://dx.doi.org/10.1345/aph.17072.

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OBJECTIVE: To review the pathophysiology and treatment of HIV wasting syndrome. DATA SOURCES AND STUDY SELECTION: MEDLINE searches (January 1987–September 1997) of the English-language medical literature were conducted. Bibliographies were also selected during a manual review. DATA SYNTHESIS: HIV-related weight loss, often referred to as HIV wasting syndrome, is a common manifestation of advanced HIV infection. Wasting in HIV involves the preferential loss of lean body mass with a paradoxical preservation of body fat. The etiology of wasting appears to be the result of many factors, which may include decreased caloric intake, malabsorption, alterations in energy expenditure and metabolism, cytokine effects, and endocrine dysfunction. Pharmacologic treatment options include appetite stimulants (e.g., dronabinol, megestrol acetate), cytokine inhibitors (e.g., thalidomide, cyproheptadine, ketotifen, pentoxifylline, fish oil, N-acetylcysteine), and anabolic agents (e.g., testosterone, nandrolone, oxandrolone, recombinant human growth hormone). CONCLUSIONS: Wasting associated with HIV has a high morbidity and mortality rate if not adequately managed. Therapeutic strategies include appetite stimulants, cytokine inhibitors, and growth-promoting agents. Selection of the appropriate agent(s) depends on the underlying cause for weight loss, adverse effects, and cost of therapy. OBJETIVO: Revisar la patofisiología y tratamiento del síndrome de desgaste causado por el VIH. FUENTES DE DATOS: Se llevó a cabo una búsqueda de la literatura médica en el idioma inglés utilizando la base de datos del MEDLINE. SÍNTESIS: La pérdida de peso asociado al VIH, también conocido como el síndrome de desgaste, es una manifestación común de la infección avanzada causada por el virus. El desgaste envuelve principalmente la pérdida de masa magra, y paradójicamente la preservación de grasa corporal. La etiología del síndrome de desgaste aparenta ser el resultado de varios factores que pueden incluir la disminución de ingesta calórica, malabsorción, alteración en la utilización de energía, alteración del metabolismo, efectos de las citoquinas, y disfunción endocrina. Las opciones para el tratamiento farmacológico incluyen estimuladores del apetito (dronabinol y acetato de megestrol), inhibidores de citoquinas (talidomida, ciproheptadina, ketotifen, pentoxyfilina, accite de pescado, y N-acetil cisteína), y agentes anabólicos (testosterona, nandrolona, oxandrolona, y la hormona de crecimiento). CONCLUSIONES: La etiología del desgaste asociado a la infección con el VIH es multifactorial. La condición conlieva una alta morbilidad y mortalidad si no es manejada adecuadamente. Las estrategías terapéuticas incluyen la estimulación de apetito, inhibidores de citoquinas y agentes que promueven el crecimiento. La selección de los agentes apropiados dependerá de la causa de la pérdida de peso, los efectos adversos, y el costo de la terapia. Aunque se necesita estudiar la condición más a fondo, la terapia combinada puede ser que resulte ser la modalidad de mayor beneficio para el paciente con el síndrome de desgaste por el VIH. OBJECTIF: Réviser la pathophysiologie et le traitement du syndrome d'émaciation associé au VIH. REVUE DE LITTÉRATURE ET SÉLECTION DES ÉTUDES: Une recherche de la documentation médicale de langue anglaise a été effectuée à l'aide de MEDLINE. Des bibliographies ont aussi été choisies grâce à une révision manuelle. RÉSUMÉ: La perte de poids associée au VIH, souvent appelée le syndrome d'émaciation, est une manifestation fréquente d'une infection avancée au VIH. l'émaciation chez les patients infectés par le VIH entraîne une perte préférentielle du tissu maigre et une conservation du tissu adipeux. l'étiologie du syndrome semble être le résultat de plusieurs facteurs dont l'ingestion calorique, la malabsorption, les modifications au niveau de la dépense énergétique et du métabolisme, les effets des cytokines, et les anormalités endocriniennes. Les options du traitement pharmacologique incluent les stimulants de l'appétit (le dronabinol et l'acétate de mégestrol), les inhibiteurs des cytokines (le thalidomide, la cyproheptadine, le kétotifène, la pentoxifylline, l'huile de poisson, et le N-acétylcystéine), et des agents anabolisants (la testostérone, le nandrolone, l'oxandrolone, et l'hormone de croissance humaine recombinée). CONCLUSIONS: Le syndrome d'émaciation associé au VIH a un taux de morbidité et de mortalité élevé s'il n'est pas adéquatement traité. Les stratégies thérapeutiques incluent les stimulants de l'appétit, les inhibiteurs des cytokines, et les agents stimulant la croissance. La sélection du ou des agents appropriés dépendra de la cause sous-jacente de la perte de poids, des effets indésirables, et du coût de la thérapie.

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Kong, Anthony, et Polly Edmonds. « Testosterone therapy in HIV wasting syndrome : systematic review and meta-analysis ». Lancet Infectious Diseases 2, n^o 11 (novembre 2002) : 692–99. http://dx.doi.org/10.1016/s1473-3099(02)00441-3.

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Sheptulin, A. A., S. S. Kardasheva, A. A. Kurbatova et V. T. Ivashkin. « Diet therapy for irritable bowel syndrome : controversial and unresolved issues ». Voprosy detskoj dietologii 18, n^o 4 (2020) : 29–35. http://dx.doi.org/10.20953/1727-5784-2020-4-29-35.

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The review considers modern approaches to diet therapy of irritable bowel syndrome (IBS). Along with general recommendations on eating regimens most commonly used nowadays in treatment of IBS, attention is paid to the lactose-free diet, gluten-free diet and the low-FODMAP diet. As is pointed out, there are contradictions in the published data concerning the effectiveness of these diets. The authors come to the conclusion that many important aspects of diet therapy for IBS remain insufficiently studied and further research is needed. Key words: irritable bowel syndrome, lactose-free diet, gluten-free diet, low-FODMAP diet

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Zafonte, Ross D., et Nancy R. Mann. « Cerebral salt wasting syndrome in brain injury patients : A potential cause of hyponatremia ». Archives of Physical Medicine and Rehabilitation 78, n^o 5 (mai 1997) : 540–42. http://dx.doi.org/10.1016/s0003-9993(97)90173-8.

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Amankwah, Samuel, et Henry G. Fein. « Hyperaldosteronism in a Patient With Gastrointestinal Potassium Wasting ». Journal of the Endocrine Society 5, Supplement_1 (1 mai 2021) : A134. http://dx.doi.org/10.1210/jendso/bvab048.270.

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Abstract Background: Medical conditions causing hypokalemia can be masked by a diet very rich in potassium. The following case presents a patient who developed new onset symptoms of hypokalemia after immigrating to the United States. Clinical Case: A 35 year old man, native of Mali, had a history of intermittent muscle spasms and serum potassium of 3.0 mmol/L first recognized elsewhere in 2019. He was not on any home medications. He was admitted with postprandial generalized abdominal pain, diarrhea, and bright blood in his stools. Serum potassium was 2.7 (nl 3.5–5.1mmol/L). He required at least 120 mEq of intravenous and oral potassium chloride per day while hospitalized to achieve and maintain serum potassium in the normal range. Colonoscopy found segmental colitis and it was thought that his hypokalemia was due to gastrointestinal losses. However, studies demonstrated urinary potassium wasting. A 1.9 cm nodular mass of the left adrenal gland was found on CT of the abdomen, and the differential diagnosis was expanded to include hypokalemia secondary to primary hyperaldosteronism or renal tubulopathies such as Bartter and Gitleman syndromes. The patient was normotensive and had biochemical findings that were consistent with Bartter syndrome including metabolic alkalosis, hypercalciuria, elevated urine sodium and chloride, and normal serum magnesium levels. However, he had low plasma rennin activity with an elevated serum aldosterone on three tests over two months (the last test was more than one month after normalization of bowel function). On all of these, the aldosterone to renin ratio was greater than 20 ng/mL/hour. The persistent suppression of plasma rennin with elevated aldosterone in the setting of left adrenal mass narrowed the differential diagnosis to primary hyperaldosteronism, as elevated rennin would be expected in Bartter syndrome. Since discharge, he has received 80 meq of daily oral potassium in divided doses, which has kept serum potassium at or below the lower limit of normal. Further management will consist of either pharmacologic or surgical treatment with or without adrenal venous sampling. Conclusion: The patient had hypokalemia for which an endocrine etiology could have been easily overlooked and attributed to gastrointestinal losses. This case demonstrates the very close clinical similarities between primary hyperaldosteronism and renal tubulopathies. However, there are biochemical patterns that can be relied on to help differentiate amongst these disorders. This patient with primary hyperaldosteronism may not have been hypokalemic in his native country due to consuming a diet rich in potassium.

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Bekker, Yvonne A. C., Danielle A. Lambrechts, Judith S. Verhoeven, Jessy van Boxtel, Caroline Troost, Erik-Jan Kamsteeg, Michèl A. Willemsen et Hilde M. H. Braakman. « Failure of ketogenic diet therapy in GLUT1 deficiency syndrome ». European Journal of Paediatric Neurology 23, n^o 3 (mai 2019) : 404–9. http://dx.doi.org/10.1016/j.ejpn.2019.02.012.

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Abrigo, Johanna, Juan Carlos Rivera, Javier Aravena, Daniel Cabrera, Felipe Simon, Fernando Ezquer, Marcelo Ezquer et Claudio Cabello-Verrugio. « High Fat Diet-Induced Skeletal Muscle Wasting Is Decreased by Mesenchymal Stem Cells Administration : Implications on Oxidative Stress, Ubiquitin Proteasome Pathway Activation, and Myonuclear Apoptosis ». Oxidative Medicine and Cellular Longevity 2016 (2016) : 1–13. http://dx.doi.org/10.1155/2016/9047821.

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Obesity can lead to skeletal muscle atrophy, a pathological condition characterized by the loss of strength and muscle mass. A feature of muscle atrophy is a decrease of myofibrillar proteins as a result of ubiquitin proteasome pathway overactivation, as evidenced by increased expression of the muscle-specific ubiquitin ligases atrogin-1 and MuRF-1. Additionally, other mechanisms are related to muscle wasting, including oxidative stress, myonuclear apoptosis, and autophagy. Stem cells are an emerging therapy in the treatment of chronic diseases such as high fat diet-induced obesity. Mesenchymal stem cells (MSCs) are a population of self-renewable and undifferentiated cells present in the bone marrow and other mesenchymal tissues of adult individuals. The present study is the first to analyze the effects of systemic MSC administration on high fat diet-induced skeletal muscle atrophy in the tibialis anterior of mice. Treatment with MSCs reduced losses of muscle strength and mass, decreases of fiber diameter and myosin heavy chain protein levels, and fiber type transitions. Underlying these antiatrophic effects, MSC administration also decreased ubiquitin proteasome pathway activation, oxidative stress, and myonuclear apoptosis. These results are the first to indicate that systemically administered MSCs could prevent muscle wasting associated with high fat diet-induced obesity and diabetes.

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Han, Min Jeong, Soon Chul Kim, Chan Uhng Joo et Sun Jun Kim. « Cerebral salt-wasting syndrome in a child with Wernicke encephalopathy treated with fludrocortisone therapy ». Medicine 95, n^o 36 (septembre 2016) : e4393. http://dx.doi.org/10.1097/md.0000000000004393.

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de Miguel, Ricardo, Javier Asín, Ana Rodríguez-Largo, Irache Echeverría, Delia Lacasta, Pedro Pinczowski, Marina Gimeno et al. « Growth Performance and Clinicopathological Analyses in Lambs Repetitively Inoculated with Aluminum-Hydroxide Containing Vaccines or Aluminum-Hydroxide Only ». Animals 11, n^o 1 (11 janvier 2021) : 146. http://dx.doi.org/10.3390/ani11010146.

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Aluminum (Al) hydroxide is an effective adjuvant used in sheep vaccines. However, Al-adjuvants have been implicated as potential contributors to a severe wasting syndrome in sheep—the so-called ovine autoimmune-inflammatory syndrome induced by adjuvants (ASIA syndrome). This work aimed to characterize the effects of the repetitive injection of Al-hydroxide containing products in lambs. Four flocks (Flocks 1–4; n = 21 each) kept under different conditions were studied. Three groups of seven lambs (Vaccine, Adjuvant-only, and Control) were established in each flock. Mild differences in average daily gain and fattening index were observed, indicating a reduced growth performance in Vaccine groups, likely related to short-term episodes of pyrexia and decreased daily intake. Clinical and hematological parameters remained within normal limits. Histology showed no significant differences between groups, although there was a tendency to present a higher frequency of hyperchromatic, shrunken neurons in the lumbar spinal cord in the Adjuvant-only group. Although Al-hydroxide was linked to granulomas at the injection site and behavioral changes in sheep, the results of the present experimental work indicate that injected Al-hydroxide is not enough to fully reproduce the wasting presentation of the ASIA syndrome. Other factors such as sex, breed, age, production system, diet or climate conditions could play a role.

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de Miguel, Ricardo, Javier Asín, Ana Rodríguez-Largo, Irache Echeverría, Delia Lacasta, Pedro Pinczowski, Marina Gimeno et al. « Growth Performance and Clinicopathological Analyses in Lambs Repetitively Inoculated with Aluminum-Hydroxide Containing Vaccines or Aluminum-Hydroxide Only ». Animals 11, n^o 1 (11 janvier 2021) : 146. http://dx.doi.org/10.3390/ani11010146.

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Aluminum (Al) hydroxide is an effective adjuvant used in sheep vaccines. However, Al-adjuvants have been implicated as potential contributors to a severe wasting syndrome in sheep—the so-called ovine autoimmune-inflammatory syndrome induced by adjuvants (ASIA syndrome). This work aimed to characterize the effects of the repetitive injection of Al-hydroxide containing products in lambs. Four flocks (Flocks 1–4; n = 21 each) kept under different conditions were studied. Three groups of seven lambs (Vaccine, Adjuvant-only, and Control) were established in each flock. Mild differences in average daily gain and fattening index were observed, indicating a reduced growth performance in Vaccine groups, likely related to short-term episodes of pyrexia and decreased daily intake. Clinical and hematological parameters remained within normal limits. Histology showed no significant differences between groups, although there was a tendency to present a higher frequency of hyperchromatic, shrunken neurons in the lumbar spinal cord in the Adjuvant-only group. Although Al-hydroxide was linked to granulomas at the injection site and behavioral changes in sheep, the results of the present experimental work indicate that injected Al-hydroxide is not enough to fully reproduce the wasting presentation of the ASIA syndrome. Other factors such as sex, breed, age, production system, diet or climate conditions could play a role.

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Rożniata, M., K. Zujko et M. E. Zujko. « Prevention and nutritional therapy of metabolic syndrome ». Progress in Health Sciences 7, n^o 2 (29 décembre 2017) : 100–104. http://dx.doi.org/10.5604/01.3001.0010.7855.

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The term metabolic syndrome (MetS) defines the cooccurrence of the related risk factors of metabolic origin that promote the development of cardiovascular diseases with atherosclerotic background and type 2 diabetes. The diagnostic criteria of MetS have undergone modifications for years. Until now no clear definition of MetS has been established. The latest diagnostic criteria of MetS published in 2009 by a group of IDF (International Diabetes Federation) and AHA/NHLBI (American Heart Association/ National Heart, Lung and Blood Institute) experts discern three out of five risk factors: abdominal obesity (taking into consideration population differences), elevated level of triglycerides, reduced HDL cholesterol, hypertension and fasting hyperglycemia. Genetic predispositions and environmental factors, such as lack of physical activity and improper diet are considered to be responsible for MetS development. Therefore, prevention and treatment of MetS should be based first of all on a change in modifiable lifestyle factors, among which proper diet is of essential importance.

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Nolan, David, Mina John et Simon Mallal. « Antiretoviral Therapy and the Lipodystrophy Syndrome, Part 2 : Concepts in Aetiopathogenesis ». Antiviral Therapy 6, n^o 3 (1 avril 2000) : 145–60. http://dx.doi.org/10.1177/135965350100600301.

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Clinical research has indicated that the use of nucleoside reverse transcriptase inhibitor (NRTI) and HIV protease inhibitor (PI) therapy is associated with a risk of long-term toxicity syndromes, and that the aetiopathogenesis of these adverse effects is independent of the antiretroviral effects of these drugs. In relation to the lipodystrophy syndrome, it appears that the most powerful determinant of subcutaneous fat wasting is an interaction between these two drug classes. In this review, possible mechanisms underlying the contributions of both PI and NRTI drugs are reviewed, with an emphasis on their effects on adipose tissue. On this basis, an ‘adipocentric’, or minimal model of the syndrome is developed, in which divergent effects at the adipocyte of NRTIs (mitochondrial toxicity) and PIs (insulin resistance and impaired adipocyte maturation) interact to produce a phenotype that is consistent with clinical observations.

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Pilipenko, V. I., et V. A. Isakov. « Diet therapy in patients with irritable bowel syndrome : FODMAP content restriction ». Voprosy dietologii 10, n^o 3 (2020) : 40–45. http://dx.doi.org/10.20953/2224-5448-2020-3-40-45.

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Restriction of the intake of fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) decreases the intensity of symptoms in patients with irritable bowel syndrome (IBS). Due to the osmoticity of FODMAP molecules the volume of intestinal contents increases, and their fermentation by microbiota results in gas production, which causes distention of the bowel wall and manifests itself as abdominal pain and bloating, diarrhoea in patients with IBS. Based on analysis of publications dealing with the effectiveness and safety of a low-FODMAP content diet, the main principles, methodology and possible difficulties of diet therapy in patients with IBS are discussed. Key words: carbohydrate malabsorption, low-FODMAP diet, diet therapy, irritable bowel syndrome

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Philip, Prijo, et Chinthu Sara Jacob. « Proximal renal tubular acidosis with primary Fanconi syndrome ». International Journal of Contemporary Pediatrics 5, n^o 3 (20 avril 2018) : 1131. http://dx.doi.org/10.18203/2349-3291.ijcp20181556.

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Renal tubular acidosis (RTA) is associated with normal or near normal glomerular filtration rate. Proximal RTA is associated with impaired bicarbonate reabsorption. This is manifested as bicarbonate wastage in the urine, and this reflects the defect in proximal tubular transport. Osteopenia or full-blown rickets may develop. Type 2 RTA is rare and occurs in association with conditions such as Fanconi syndrome. This is manifested as glycosuria, aminoaciduria, phosphate wasting and mild proteinuria. The basis of therapy is the continuous administration of appropriate amounts of alkali in the form of either bicarbonate or citrate, as well as the treatment of the cause.

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Kaneko, Kyle. « The Ketogenic Diet as a Potential Therapy in Down syndrome ». Journal of Pediatrics and Pediatric Medicine 2, n^o 2 (1 mars 2018) : 11–17. http://dx.doi.org/10.29245/2578-2940/2018/2.1121.

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Saint-Marc, Thierry, Maria Partisani, Isabelle Poizot-Martin, Franck Bruno, Olivier Rouviere, Jean-Marie Lang, Jean-Albert Gastaut et Jean-Louis Touraine. « A syndrome of peripheral fat wasting (lipodystrophy) in patients receiving long-term nucleoside analogue therapy ». AIDS 13, n^o 13 (septembre 1999) : 1659–67. http://dx.doi.org/10.1097/00002030-199909100-00009.

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Basaria, Shehzad, Justin T. Wahlstrom et Adrian S. Dobs. « Anabolic-Androgenic Steroid Therapy in the Treatment of Chronic Diseases ». Journal of Clinical Endocrinology & ; Metabolism 86, n^o 11 (1 novembre 2001) : 5108–17. http://dx.doi.org/10.1210/jcem.86.11.7983.

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The purpose of this study was to review the preclinical and clinical literature relevant to the efficacy and safety of anabolic androgen steroid therapy for palliative treatment of severe weight loss associated with chronic diseases. Data sources were published literature identified from the Medline database from January 1966 to December 2000, bibliographic references, and textbooks. Reports from preclinical and clinical trials were selected. Study designs and results were extracted from trial reports. Statistical evaluation or meta-analysis of combined results was not attempted. Androgenic anabolic steroids (AAS) are widely prescribed for the treatment of male hypogonadism; however, they may play a significant role in the treatment of other conditions as well, such as cachexia associated with human immunodeficiency virus, cancer, burns, renal and hepatic failure, and anemia associated with leukemia or kidney failure. A review of the anabolic effects of androgens and their efficacy in the treatment of these conditions is provided. In addition, the numerous and sometimes serious side effects that have been known to occur with androgen use are reviewed. Although the threat of various side effects is present, AAS therapy appears to have a favorable anabolic effect on patients with chronic diseases and muscle catabolism. We recommend that AAS can be used for the treatment of patients with acquired immunodeficiency syndrome wasting and in severely catabolic patients with severe burns. Preliminary data in renal failure-associated wasting are also positive. Advantages and disadvantages should be weighed carefully when comparing AAS therapy to other weight-gaining measures. Although a conservative approach to the use of AAS in patients with chronic diseases is still recommended, the utility of AAS therapy in the attenuation of severe weight loss associated with disease states such as cancer, postoperative recovery, and wasting due to pulmonary and hepatic disease should be more thoroughly investigated.

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Ravasco, P., I. Monteiro Grillo et M. Camilo. « Colorectal cancer nutritional and quality-of-life parameters predict patients outcomes after radiotherapy : Long-term follow-up from a prospective randomized controlled trial ». Journal of Clinical Oncology 25, n^o 18_suppl (20 juin 2007) : 14570. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.14570.

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14570 Background: Long term data of our published randomized trial of nutritional therapy in colorectal cancer showed that nutritional counseling optimizes pts prognosis. This study aimed to search whether outcomes were affected by individual nutritional & Quality of Life (QoL) parameters after nutrition intervention and radiotherapy (RT). Methods: Data were obtained from the trial pts’ records: G1 (n=37) on individualized nutritional counseling & education (regular foods), G2 (n=37) ad lib+polymeric protein supplements & G3 (n=37) ad lib intake. After RT, current intake (diet history), nutritional status (PG-SGA) & QoL scores (EORTC) were evaluated; their ability to predict survival, disease outcome [loco regional recurrence (LRR), distant metastases] & late RT toxicity (permanent flatulence, abdominal distension, diarrhea) were analyzed after a median follow-up of 3.7 (2.0–5.8) yrs. Results: Energy/protein intakes had decreased in G3 (p<0.01) & increased in G1>G2, p=0.007; wasting only occurred in G3>G2 (p<0.05); QoL scores worsened in G3>G2 (p<0.05) yet improved in G1, p<0.01. On multivariate analyzis of coded time-dependent variables: poorer diet intake, nutritional wasting & worse QoL scores were associated with decreased survival (p<0.002), LRR (p=0.01), distant metastases (p=0.005) & late RT toxicity, p<0.003. Landmark analysis showed that pts with nutritional intake/status & QoL deterioration, had significantly lower survival (hazard ratio [HR]: 8.25; 95% CI 2.74–26.47; p<0.001), worse disease outcome (HR: 8.15; 95% CI 2.22–25.40; p<0.002) & more severe late RT toxicity (HR: 7.15; 95% CI 2.25–16.11; p<0.004). Conclusions: In colorectal cancer after RT, poor diet intake, wasting & deteriorated QoL look as if significant predictors of survival, treatment response & late RT toxicity; such patients are prone to a more aggressive clinical course. No significant financial relationships to disclose.

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Aquila, Giorgio, Andrea David Re Cecconi, Jeffrey J. Brault, Oscar Corli et Rosanna Piccirillo. « Nutraceuticals and Exercise against Muscle Wasting during Cancer Cachexia ». Cells 9, n^o 12 (24 novembre 2020) : 2536. http://dx.doi.org/10.3390/cells9122536.

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Cancer cachexia (CC) is a debilitating multifactorial syndrome, involving progressive deterioration and functional impairment of skeletal muscles. It affects about 80% of patients with advanced cancer and causes premature death. No causal therapy is available against CC. In the last few decades, our understanding of the mechanisms contributing to muscle wasting during cancer has markedly increased. Both inflammation and oxidative stress (OS) alter anabolic and catabolic signaling pathways mostly culminating with muscle depletion. Several preclinical studies have emphasized the beneficial roles of several classes of nutraceuticals and modes of physical exercise, but their efficacy in CC patients remains scant. The route of nutraceutical administration is critical to increase its bioavailability and achieve the desired anti-cachexia effects. Accumulating evidence suggests that a single therapy may not be enough, and a bimodal intervention (nutraceuticals plus exercise) may be a more effective treatment for CC. This review focuses on the current state of the field on the role of inflammation and OS in the pathogenesis of muscle atrophy during CC, and how nutraceuticals and physical activity may act synergistically to limit muscle wasting and dysfunction.

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Mabillard, Holly, Hilary Tedd, Ally Speight, Christopher Duncan, David A. Price et John A. Sayer. « Case Report : Renal potassium wasting in SARS-CoV-2 infection ». F1000Research 9 (30 juin 2020) : 659. http://dx.doi.org/10.12688/f1000research.24621.1.

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with many potentially fatal complications. Renal involvement in various forms is common in addition to serum electrolyte disturbances. Early reports suggest that hypokalaemia may frequent those with SARS-CoV-2 infection and various aetiological factors may cause this electrolyte disturbance. A Chinese retrospective study has demonstrated renal potassium wasting in patients infected with SARS-CoV-2, however, it is not known if these patients were receiving diuretic therapy which may be a contributing factor. This case report illustrates an example of renal potassium wasting in SARS-CoV-2 infection in the absence of diuretics and extra-renal mechanisms with important lessons learned.

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Mabillard, Holly, Hilary Tedd, Ally Speight, Christopher Duncan, David A. Price et John A. Sayer. « Case Report : Renal potassium wasting in SARS-CoV-2 infection ». F1000Research 9 (13 novembre 2020) : 659. http://dx.doi.org/10.12688/f1000research.24621.2.

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with many potentially fatal complications. Renal involvement in various forms is common in addition to serum electrolyte disturbances. Early reports suggest that hypokalaemia may frequent those with SARS-CoV-2 infection and various aetiological factors may cause this electrolyte disturbance. A Chinese retrospective study has demonstrated renal potassium wasting in patients infected with SARS-CoV-2, however, it is not known if these patients were receiving diuretic therapy which may be a contributing factor. This case report illustrates an example of renal potassium wasting in SARS-CoV-2 infection in the absence of diuretics and extra-renal mechanisms with important lessons learned.

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Ivanova, A. A., M. N. Lebedeva, S. A. Pervukhin et Yu V. Abysheva. « Clinical case of combined diabetes insipidus and cerebral salt-wasting syndrome in a patient with craniocerebral and spinal injury ». Acta Biomedica Scientifica 6, n^o 4 (17 octobre 2021) : 137–45. http://dx.doi.org/10.29413/abs.2021-6.4.12.

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Introduction. Cerebral salt-wasting syndrome and diabetes insipidus are serious complications of craniocerebral injury and spinal cord injuries. Each of the syndromes in some cases causes a life-threatening condition. This determines the importance of timely diagnosis and emergency intensive care measures. In the literature, there are only single descriptions of combinations of these symptoms in one patient.Clinical case report. A victim with craniocerebral injury and cervical spinal cord injury underwent, according to emergency indications, emptying and drainage of a tense subgaleal hematoma of the fronto-parieto-occipital region, spinal cord decompression, and stabilization of the spine. Postoperative follow-up and intensive care: on the 1st day the rate of diuresis was 2.5 mL/kg/h, blood glucose level – 14.18 mmol/L, and sodium level – 148–158 mmol/L. The patient was diagnosed with diabetes insipidus, and a therapy with desmopressin at a dose of 0.6 mg/day, restoration of fluid volume with hypotonic solutions, and correction of hyperglycemia was started. On the 4th day blood sodium level was 133 mmol/L, and blood glucose level – 8.67 mmol/L. On the 5th day, hyponatremia of 126–115 mmol/L was noted with a diuresis rate of 4 mL/kg/h and glicemya level of 7.86 mmol/L. The development of cerebral salt-wasting syndrome was diagnosed, and the infusion of hydrocortisone 400 mg/day and of 10% NaCl solution was started. On the 6th day glucose level returned to normal. On the 9th day of follow-up, an increase in the volume of diuresis was again observed, and desmopressin therapy was continued. Stable normalization of water-electrolyte balance, urine output, and glucose levels were observed on the 16th day of follow-up.Conclusion. Monitoring of fluid balance and electrolyte composition of blood serum, and adequate replacement therapy were the conditions for successful treatment of a rare combination of diabetes insipidus and cerebral salt-wasting syndrome in patients with concomitant craniocerebral and spinal cord injuries.

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Pham, Phuong-Chi, Pavani Reddy, Shaker Qaqish, Ashvin Kamath, Johana Rodriguez, David Bolos, Martina Zalom et Phuong-Thu Pham. « Cisplatin-Induced Renal Salt Wasting Requiring over 12 Liters of 3% Saline Replacement ». Case Reports in Nephrology 2017 (2017) : 1–4. http://dx.doi.org/10.1155/2017/8137078.

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Cisplatin is known to induce Fanconi syndrome and renal salt wasting (RSW). RSW typically only requires transient normal saline (NS) support. We report a severe RSW case that required 12 liters of 3% saline. A 57-year-old woman with limited stage small cell cancer was admitted for cisplatin (80 mg/m2) and etoposide (100 mg/m2) therapy. Patient’s serum sodium (SNa) decreased from 138 to 133 and 125 mEq/L within 24 and 48 hours of cisplatin therapy, respectively. A diagnosis of syndrome of inappropriate antidiuretic hormone secretion (SIADH) was initially made. Despite free water restriction, patient’s SNa continued to decrease in association with acute onset of headaches, nausea, and dizziness. Three percent saline (3%S) infusion with rates up to 1400 mL/day was required to correct and maintain SNa at 135 mEq/L. Studies to evaluate Fanconi syndrome revealed hypophosphatemia and glucosuria in the absence of serum hyperglycemia. The natriuresis slowed down by 2.5 weeks, but 3%S support was continued for a total volume of 12 liters over 3.5 weeks. Attempts of questionable benefits to slow down glomerular filtration included the administration of ibuprofen and benazepril. To our knowledge, this is the most severe case of RSW ever reported with cisplatin.

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Sharafetdinov, Kh Kh, M. V. Zeygarnik, B. S. Kaganov, A. N. Safronova, A. V. Yudochkin et E. A. Zuglova. « Metabolic syndrome : modern ideas, diagnostic criteria and principles of diet therapy ». Voprosy dietologii 5, n^o 4 (2015) : 4–13. http://dx.doi.org/10.20953/2224-5448-2015-4-4-13.

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Sullivan, Shelby, et Samuel Samuel. « Effect of Short-Term Pritikin Diet Therapy on the Metabolic Syndrome ». Journal of the CardioMetabolic Syndrome 1, n^o 5 (septembre 2006) : 308–12. http://dx.doi.org/10.1111/j.1559-4564.2006.05732.x.

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Floch, Martin H. « Use of Diet and Probiotic Therapy in the Irritable Bowel Syndrome ». Journal of Clinical Gastroenterology 39, Supplement 3 (mai 2005) : S243—S246. http://dx.doi.org/10.1097/01.mcg.0000156104.67505.5b.

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Simrén, Magnus. « Diet as a Therapy for Irritable Bowel Syndrome : Progress at Last ». Gastroenterology 146, n^o 1 (janvier 2014) : 10–12. http://dx.doi.org/10.1053/j.gastro.2013.11.027.

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Hirano, Yoshiko, Hirokazu Oguni, Mutuko Shiota, Aiko Nishikawa et Makiko Osawa. « Ketogenic diet therapy can improve ACTH-resistant West syndrome in Japan ». Brain and Development 37, n^o 1 (janvier 2015) : 18–22. http://dx.doi.org/10.1016/j.braindev.2014.01.015.

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Ghitea, Timea Claudia. « Correlation of Periodontal Bacteria with Chronic Inflammation Present in Patients with Metabolic Syndrome ». Biomedicines 9, n^o 11 (18 novembre 2021) : 1709. http://dx.doi.org/10.3390/biomedicines9111709.

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Metabolic syndrome (MS) is correlated with many chronic diseases, and so far is moderately followed and treated. The present study follows a correlation of the presence of pathogens (Fusobacterium nucleatum, Bacteroides forsythus, and others) in the gingival crevicular fluid and MS. (1) An important role in the fight against MS is to reduce fat mass, inflammatory mediators, and prevent cytokine-associated diseases. (2) A group of 111 people with MS was studied, divided into 3 groups. The control group (CG) received no treatment for either periodontitis or MS. The diet therapy group (DG) followed a clinical diet therapy specific to MS, and the diet therapy and sports group (DSG) in addition to diet therapy introduced regular physical activity; (3) A statistically significant worsening of periodontopathogens was observed correlated with the advancement of MS (increase in fat mass, visceral fat, and ECW/TBW ratio) in the CG group. In the case of DG and DSG groups, an improvement of the parameters was observed, including periodontal diseases. Therefore, anti-inflammatory diet therapy contributes to the reduction of gingival inflammation and thus contributes to the reduction of the development of pathogenic bacteria in the gingival, responsible for the development of periodontal disease and directly by other chronic diseases.

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Rej, Anupam, Amanda Avery, Alexander Charles Ford, Anne Holdoway, Matthew Kurien, Yvonne McKenzie, Julie Thompson et al. « Clinical Application of Dietary Therapies in Irritable Bowel Syndrome ». Journal of Gastrointestinal and Liver Diseases 27, n^o 3 (30 septembre 2018) : 307–16. http://dx.doi.org/10.15403/jgld.2014.1121.273.avy.

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Background & Aims: Diet appears to play a pivotal role in symptom generation in Irritable Bowel Syndrome (IBS). First line dietary therapy for IBS has focused on advice concerning healthy eating and lifestyle management. Research recently has focused on the role of a diet low in fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs), gluten free (GFD) and wheat free (WFD) diets for the relief of symptoms in IBS.Methods: A round table discussion with gastroenterologists and dietitians with a specialist interest in dietary therapies in IBS was held in Sheffield, United Kingdom in May 2017. Existing literature was reviewed. PubMed and EMBASE were searched with the MeSH terms irritable bowel syndrome/diet/diet therapy/gluten/low FODMAP in different combinations to identify relevant articles. A consensus on the application of these dietary therapies into day-to-day practice was developed. Results: Fourteen randomized trials in IBS evaluating the low FODMAP diet (n studies = 9), GFD (n = 4) and WFD (n = 1) were included in this review. The total number of patients recruited from randomized trials reviewed was: n=580 low FODMAP diet (female, n=430), n=203 GFD (female, n=139), n=276 WFD (female, n=215). There was no significant difference in the gender of patients recruited for both the low FODMAP and GFD randomized studies (p=0.12). The response rate in the literature to a low FODMAP diet ranged between 50-76%, and to GFD ranged between 34-71%. Percentage of IBS patients identified as wheat sensitive was reported as 30% in the literature. Conclusion: There are no head-to-head trials to date utilizing the low FODMAP diet, GFD and WFD for dietary treatment of IBS and still a number of concerns for diets, including nutritional inadequacy and alteration of the gut microbiota. The consensus suggests that there is evidence for the use of the low FODMAP diet, GFD and WFD as dietary therapies for IBS; the decision-making process for using each individual therapy should be directed by a detailed history by the dietitian, involving the patient in the process.

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Kim, Min Ji. « Nutrition Therapy for Diabetic Patients with Malnutrition ». Journal of Korean Diabetes 23, n^o 4 (31 décembre 2022) : 258–61. http://dx.doi.org/10.4093/jkd.2022.23.4.258.

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Recently, the prevalence of diabetic mellitus patients in Korea has been increasing, and it increasing with age. The treatment goal of diabetes is to prevent complications through blood sugar management, for which it is important to maintain an appropriate nutritional state. Unbalanced diet refers to excessive or insufficient nutrition, which can be generally confirmed through weight conditions. Therefore, medical nutrition therapy in diabetic patients with unbalanced diet aims to maintain a moderate body mass index. Older people with diabetes have a higher risk of unbalanced diet than those without diabetes. Clinical nutritional intervention in diabetic patients should shift from strict dietary restrictions for treatment of metabolic syndrome/obesity to diet for prevention of frailty and sarcopenia with age. Therefore, clinical nutrition therapy for diabetic patients with unbalanced diet should be individualized in consideration of age, gender, and medical condition. Medical nutrition therapy tailored for each patient can contribute to improving the nutritional status of diabetic patients, prolonging healthy life expectancy and improving quality of life.

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Berkenbosch, John W., Christopher W. Lentz, David F. Jimenez et Joseph D. Tobias. « Cerebral Salt Wasting Syndrome following Brain Injury in Three Pediatric Patients : Suggestions for Rapid Diagnosis and Therapy ». Pediatric Neurosurgery 36, n^o 2 (2002) : 75–79. http://dx.doi.org/10.1159/000048356.

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Strawford, A., R. Hoh, R. Neese et M. Hellerstein. « The effects of combination megestrol acetate (MA) and testosterone (T) replacement therapy in AIDS wasting syndrome (AWS) ». Nutrition 13, n^o 3 (mars 1997) : 276. http://dx.doi.org/10.1016/s0899-9007(97)82654-8.

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Knoops, K. T. B., L. C. P. G. M. de Groot, D. Kromhout, K. Esposito, R. Mariella et M. Ciotola. « Mediterranean Diet for Reducing Mortality and Easing the Metabolic Syndrome ». Physician and Sportsmedicine 33, n^o 5 (janvier 2005) : 8–16. http://dx.doi.org/10.1080/23263660.2005.11675755.

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Gnatenko, T. М. « The Issues Concerning the Diet Therapy of Acetonemic Vomiting Syndrome in Children ». CHILD`S HEALTH, n^o 5.1.73.1 (31 octobre 2016) : 107. http://dx.doi.org/10.22141/2224-0551.5.1.73.1.2016.78952.

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Coleman, Janet E., et Alan R. Watson. « Hyperlipidaemia, diet and simvastatin therapy in steroid-resistant nephrotic syndrome of childhood ». Pediatric Nephrology 10, n^o 2 (1 mars 1996) : 171–74. http://dx.doi.org/10.1007/s004670050089.

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Coleman, Janet E., et Alan R. Watson. « Hyperlipidaemia, diet and simvastatin therapy in steroid-resistant nephrotic syndrome of childhood ». Pediatric Nephrology 10, n^o 2 (avril 1996) : 171–74. http://dx.doi.org/10.1007/bf00862065.

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Garbicz, Jagoda, Beata Całyniuk, Michał Górski, Marta Buczkowska, Małgorzata Piecuch, Aleksandra Kulik et Piotr Rozentryt. « Nutritional Therapy in Persons Suffering from Psoriasis ». Nutrients 14, n^o 1 (28 décembre 2021) : 119. http://dx.doi.org/10.3390/nu14010119.

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Psoriasis is a chronic inflammatory skin disease. Immunological, genetic, and environmental factors, including diet, play a part in the pathogenesis of psoriasis. Metabolic syndrome or its components are frequent co-morbidities in persons with psoriasis. A change of eating habits can improve the quality of life of patients by relieving skin lesions and by reducing the risk of other diseases. A low-energy diet is recommended for patients with excess body weight. Persons suffering from psoriasis should limit the intake of saturated fatty acids and replace them with polyunsaturated fatty acids from the omega-3 family, which have an anti-inflammatory effect. In diet therapy for persons with psoriasis, the introduction of antioxidants such as vitamin A, vitamin C, vitamin E, carotenoids, flavonoids, and selenium is extremely important. Vitamin D supplementation is also recommended. Some authors suggest that alternative diets have a positive effect on the course of psoriasis. These diets include: a gluten-free diet, a vegetarian diet, and a Mediterranean diet. Diet therapy for patients with psoriasis should also be tailored to pharmacological treatment. For instance, folic acid supplementation is introduced in persons taking methotrexate. The purpose of this paper is to discuss in detail the nutritional recommendations for persons with psoriasis.

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Domański, Maciej, et Kazimierz Ciechanowski. « Sarcopenia : A Major Challenge in Elderly Patients with End-Stage Renal Disease ». Journal of Aging Research 2012 (2012) : 1–12. http://dx.doi.org/10.1155/2012/754739.

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Sarcopenia is a condition of multifaceted etiology arising in many elderly people. In patients with chronic kidney, the loss of muscle mass is much more intensive and the first signs of sarcopenia are observed in younger patients than it is expected. It is associated with the whole-body protein-energy deficiency called protein-energy wasting (PEW). It seems to be one of the major factors limiting patient's autonomy as well as decreasing the quality of life. If it cannot be treated with the simple methods requiring some knowledge and devotion, we will fail to save patients who die due to cardiovascular disease and infection, despite proper conduction of renal replacement therapy. Many factors influencing the risk of sarcopenia development have been evaluated in number of studies. Many studies also were conducted to assess the efficacy of different therapeutic strategies (diet, physical activity, hormones). Nevertheless, there is still no consensus on treatment the patients with PEW. Therefore, in the paper we present the reasons and pathophysiology of sarcopenia as an important element of protein energy wasting (PEW) in elderly patients suffering from chronic kidney disease. We also analyze possible options for treatment according to up-to-date knowledge.

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Miller, Karen, Colleen Corcoran, Catharina Armstrong, Kim Caramelli, Ellen Anderson, Deborah Cotton, Nesli Basgoz et al. « Transdermal Testosterone Administration in Women with Acquired Immunodeficiency Syndrome Wasting : A Pilot Study1 ». Journal of Clinical Endocrinology & ; Metabolism 83, n^o 8 (1 août 1998) : 2717–25. http://dx.doi.org/10.1210/jcem.83.8.5051.

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abstract Although human immunodeficiency virus (HIV) disease is increasing rapidly among women, no prior studies have investigated gender-based therapeutic strategies for the treatment of acquired immunodeficiency syndrome (AIDS) and its complications in this population. Markedly decreased serum androgen levels have been demonstrated in women with AIDS and may be a contributing factor to the wasting syndrome in this population. To assess the effects of androgen replacement therapy in women with AIDS wasting, we conducted a randomized, placebo-controlled, pilot study of transdermal testosterone administration. The primary aim of the study was to determine efficacy in terms of the change in serum testosterone levels, safety parameters and tolerability. A secondary aim of the study was to investigate testosterone effects on weight, body composition, quality of life, and functional indexes. Fifty-three ambulatory women with the AIDS wasting syndrome defined as weight less than 90% of ideal body weight or weight loss of more than 10% of the preillness maximum, free of new opportunistic infection within 6 weeks of study initiation, and with screening serum levels of free testosterone less than the mean of the normal reference range (<3 pg/mL) were enrolled in the study. Subjects were age 37 ± 1 yr old (mean ± sem), weighed 92 ± 2% of ideal body weight, and had lost 17 ± 1% of their maximum weight. CD4 count was 324 ± 36 cells/mm3, and viral burden was 102,382 ± 28,580 copies. Subjects were randomized into three treatment groups, in which two placebo patches (PP), one active/one placebo patch (AP group), or two active patches (AA group) were applied twice weekly to the abdomen for 12 weeks. The expected nominal delivery rates of testosterone were 150 and 300 μg/day, respectively, for the AP and AA groups. Forty-five subjects completed the study (PP group, n = 13; AP group, n = 14; AA group, n = 18). Two additional subjects from the PP group and two from the AP group were included in the intent to treat analysis. Serum free testosterone levels increased significantly from 1.2 ± 0.2 to 5.9 ± 0.8 pg/mL (AP) and from 1.9 ± 0.4 to 12.4 ± 1.6 pg/mL (AA) in response to testosterone administration (P < 0.0001 for comparison of AA vs. PP and AP vs. PP; normal range, 1.3–6.8 pg/mL). Testosterone administration was generally well tolerated locally and systemically, with no adverse trends in hirsutism scores, lipid profiles, or liver function tests. Weight increased significantly in the AP group (1.9 ± 0.7 kg) vs. the PP group (0.6 ± 0.8 kg; P = 0.043), but did not increase significantly in the AA group (0.9 ± 0.4 kg; P = 0.263 vs. PP, by mixed effects model assessing the interaction of time and treatment on all available data, one-tailed test). Improved social functioning (P = 0.024, by one-tailed test) and a trend toward improved pain score (P = 0.059) were observed in the AP vs. the PP-treated patients (RAND 36-Item Health Survey questionnaire). Five of six previously amenorrheic patients in the AP group had spontaneous resumption of menses compared to only one of four amenorrheic patients in the AA group (P = 0.045 for comparison of actual number of periods during the study). This study is the first investigation of testosterone administration in women with AIDS wasting. We demonstrate a novel method to augment testosterone levels in such patients that is safe and well tolerated during short term administration. At the lower of the two doses administered in this study, testosterone therapy was associated with positive trends in weight gain and quality of life. Higher, more supraphysiological, dosing was not associated with positive trends in weight or overall well-being. These data suggest that testosterone administration may improve the status of women with AIDS wasting. Further studies are needed to assess the effects of testosterone on weight in HIV-infected women and to define the optimal therapeutic window for testosterone administration in this population.

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Roche, Helen M., Catherine Phillips et Michael J. Gibney. « The metabolic syndrome : the crossroads of diet and genetics ». Proceedings of the Nutrition Society 64, n^o 3 (août 2005) : 371–77. http://dx.doi.org/10.1079/pns2005445.

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The metabolic syndrome is a very common disease associated with an increased risk of type 2 diabetes mellitus (T2DM) and CVD. The clinical characteristics of the metabolic syndrome include insulin resistance, dyslipidaemia, abdominal obesity and hypertension. The diverse clinical characteristics illustrate the complexity of the disease process, which involves several dysregulated metabolic pathways. Thus, multiple genetic targets must be involved in the pathogenesis and progression of the metabolic syndrome. Nevertheless, the human genome has not changed markedly in the last decade but the prevalence of the metabolic syndrome has increased exponentially, which illustrates the importance of gene–environmental interactions. There is good evidence that nutrition plays an important role in the development and progression of the metabolic syndrome. Indeed, obesity is a key aetiological factor in the development of the metabolic syndrome. Understanding the biological impact of gene–nutrient interactions will provide a key insight into the pathogenesis and progression of diet-related polygenic disorders, including the metabolic syndrome. The present paper will explore the interactions between genetic background and dietary exposure or nutritional therapy, focusing on the role of dietary fatty acids within the context of nutrient regulation of gene expression and individual responsiveness to dietary therapy. Only with a full understanding of gene–gene, gene–nutrient and gene–nutrient–environment interactions can the molecular basis of the metabolic syndrome be solved to minimise the adverse health effects of obesity and reduce the risk of the metabolic syndrome, and subsequent T2DM and CVD.

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Almeda-Valdes, Paloma, Roberto J. Herrera-Mercadillo, Carlos A. Aguilar-Salinas, Misael Uribe et Nahum Méndez-Sánchez. « The Role of Diet in Patients with Metabolic Syndrome ». Current Medicinal Chemistry 26, n^o 19 (12 septembre 2019) : 3613–19. http://dx.doi.org/10.2174/0929867324666170518095316.

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Metabolic syndrome is a frequent metabolic disorder characterized by obesity and insulin resistance seems to be the main pathophysiological alteration. The goal of treating metabolic syndrome is to reduce the risk of coronary heart disease and the development of type 2 diabetes. The lifestyle modification therapy combines specific recommendations on diet alone or combined with other strategies. In this review, we address the following topics: 1) the importance of the high prevalence of metabolic syndrome and obesity, and 2) the role of lifestyle modification focusing on dietary fat intake in the management of MS.

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Nucera, Eleonora, Angela Rizzi, Raffaella Chini, Sara Giangrossi, Franziska Michaela Lohmeyer, Giuseppe Parrinello, Tania Musca, Giacinto Abele Donato Miggiano, Antonio Gasbarrini et Riccardo Inchingolo. « Diet Intervention Study through Telemedicine Assistance for Systemic Nickel Allergy Syndrome Patients during the COVID-19 Pandemic ». Nutrients 13, n^o 8 (23 août 2021) : 2897. http://dx.doi.org/10.3390/nu13082897.

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Background: Restrictions due to the COVID-19 pandemic limited patients’ access to hospital care. The aims of this study were to assess dietary nutritional status, quality of life (QoL), and adherence to dietary therapy before and after 30-day personalized diet therapy through telenutrition tools in patients with systemic nickel allergic syndrome (SNAS). Methods: Each SNAS patient underwent the following allergological procedures: (a) face-to-face visit (nutritional visit and QoL evaluation) with prescription of one out of five personalized and balanced dietary plans different for calorie intake, (b) video call visit for dietary evaluation and assessment of adherence to diet after 15 days, and (c) video call visit for dietary and QoL evaluation and assessment of adherence to diet therapy after 30 days (end of study). Results: We enrolled 20 SNAS patients. After 15 and 30 days, we found a statistically significant improvement in anthropometric findings after diet therapy, a significant adherence rate to low-nickel diet (60% and 80%, respectively), and an improvement in QoL with an increase in almost all psychometric indices. Conclusions: Our study demonstrates that telenutrition can be a valid tool to monitor nutritional status and adherence to balanced low-Ni diet positively affecting QoL in SNAS patients during the COVID-19 pandemic.

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Frieling, Thomas, Jürgen Heise, Britta Krummen, Corinna Hundorf et Sigrid Kalde. « Tolerability of FODMAP – reduced diet in irritable bowel syndrome – efficacy, adherence, and body weight course ». Zeitschrift für Gastroenterologie 57, n^o 06 (14 mars 2019) : 740–44. http://dx.doi.org/10.1055/a-0859-7531.

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Abstract Background FODMAP reduced diet (fermentable oligo-, di-, monosaccharide, and polyols) belongs to the established therapy strategies in irritable bowel syndrome (IBS). However, disadvantages of this diet are significant and may lead to weight loss and insufficient patient adherence. Reports from Germany are not available yet. Material and methods In a prospective study, 93 patients with IBS according to Rom III were investigated. Sixty-three patients were recruited for the study and received standardized investigation, informed consent, and structured dietary instructions about the FODMAP reduced diet. Patients complaints were documented by a validated questionnaire and a standardized Lickert scale before and 8 weeks after the start of the diet. Stool characteristics were documented by the Bristol stool form scale. Results Patients adherence was low because 30 patients (47 %) stopped the diet. Of the remaining 33 patients, 36 % (n = 12) developed significant weight loss during the FODMAP therapy. Patients completing the study reported significant global improvement of symptoms in 79 % of cases (abdominal pain 85 %, meteorism 79 %, flatulence 69 %, borbogymi 69 %, nausea 46 %, fatigue 69 %). In addition, the severity of symptoms was significantly reduced. Fourteen patients developed changes of their stool characteristics according to the Bristol stool form scale, 11 of whom improved diarrhea and 3 improved constipation. Conclusion FODMAP reduced diet is an efficient therapy in IBS. However, adherence of the patients is poor and the therapy bears the risk of significant weight loss.

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Häfliger, Simon, Ann-Katrin Seidel, Eric Schoch, Jan Reichmann, Damian Wild, Stephanie Steinmann-Schwager et Miklos Pless. « Peptide Receptor Radionuclide Therapy for a Phosphaturic Mesenchymal Tumor ». Case Reports in Oncology 13, n^o 3 (30 novembre 2020) : 1373–80. http://dx.doi.org/10.1159/000510334.

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Tumor-induced osteomalacia is a very rare paraneoplastic syndrome. It can be caused by phosphaturic mesenchymal tumor (PMT), a generally benign tumor that produces fibroblast growth factor 23 (FGF-23), which can cause a severe renal phosphate wasting syndrome. Upon complete surgical removal of the tumor, FGF-23 normalizes and the osteomalacia is cured. In cases in which surgery is not feasible, radiofrequency ablation (RFA) is the treatment of choice. We describe a case with a PMT situated in the sacrum, in close proximity to the sacral plexus. Both surgery and RFA were considered potentially nerve damaging. Since the tumor showed expression of somatostatin receptors, we opted for a peptide receptor radionuclide therapy (PRRT) with <sup>177</sup>Lu-DOTATOC. However, the therapy did not show the expected success, since the FGF-23 level had even temporarily increased. The patient was then successfully treated with RFA. A partial remission of the tumor was achieved and FGF-23 levels nearly normalized. Despite some severe neurological side effects, the patient showed a remarkable clinical improvement, with no symptoms of osteomalacia within a few weeks.

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Boscardin, Emilie, Romain Perrier, Chloé Sergi, Marc P. Maillard, Johannes Loffing, Dominique Loffing-Cueni, Robert Koesters, Bernard C. Rossier et Edith Hummler. « Plasma Potassium Determines NCC Abundance in Adult Kidney-Specific γENaC Knockout ». Journal of the American Society of Nephrology 29, n^o 3 (25 janvier 2018) : 977–90. http://dx.doi.org/10.1681/asn.2017030345.

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The amiloride-sensitive epithelial sodium channel (ENaC) and the thiazide-sensitive sodium chloride cotransporter (NCC) are key regulators of sodium and potassium and colocalize in the late distal convoluted tubule of the kidney. Loss of the αENaC subunit leads to a perinatal lethal phenotype characterized by sodium loss and hyperkalemia resembling the human syndrome pseudohypoaldosteronism type 1 (PHA-I). In adulthood, inducible nephron-specific deletion of αENaC in mice mimics the lethal phenotype observed in neonates, and as in humans, this phenotype is prevented by a high sodium (HNa+)/low potassium (LK+) rescue diet. Rescue reflects activation of NCC, which is suppressed at baseline by elevated plasma potassium concentration. In this study, we investigated the role of the γENaC subunit in the PHA-I phenotype. Nephron-specific γENaC knockout mice also presented with salt-wasting syndrome and severe hyperkalemia. Unlike mice lacking αENaC or βΕΝaC, an HNa+/LK+ diet did not normalize plasma potassium (K+) concentration or increase NCC activation. However, when K+ was eliminated from the diet at the time that γENaC was deleted, plasma K+ concentration and NCC activity remained normal, and progressive weight loss was prevented. Loss of the late distal convoluted tubule, as well as overall reduced βENaC subunit expression, may be responsible for the more severe hyperkalemia. We conclude that plasma K+ concentration becomes the determining and limiting factor in regulating NCC activity, regardless of Na+ balance in γENaC-deficient mice.

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