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Epure, Alina, and Dan Mircea Cheța. "Detoxification therapy and diet plan for mercury, aluminium, arsene poisoning." Romanian Medical Journal 68, no. 3 (2021): 415–18. http://dx.doi.org/10.37897/rmj.2021.3.14.
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Mercury and aluminum poisoning affects the entire human body, the cumulative toxic effects being noticed especially at the cognitive, neurological and metabolic level. Toxicity with heavy metals such as mercury, aluminum, arsenic, lead is one of the biggest threats to our health. The diagnosis of mercury, aluminum and arsenic poisoning is an important step in establishing food and chelation therapy, with an emphasis on the cause, not on the symptoms. We present the case of a 46-year-old patient with symptoms manifested for a period of 2 years, who was exposed to treatments structured according to manifestations, without improving the conditions presented, without performing specific investigations of heavy metal poisoning. The personalized diet and treatment plan, used in the case of this patient, for a period of 3 months were distinguished by a total solution of the manifestations initially presented, no side effects.
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Kocatürk, R. R. "USE OF KETOGENIC DIET THERAPY IN EPILEPSY WITH MITOCHONDRIAL DYSFUNCTION: A SYSTEMATIC AND CRITICAL REVIEW." Biotechnologia Acta 15, no. 2 (2022): 15–36. http://dx.doi.org/10.15407/biotech15.02.015.
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With the development of molecular techniques over time more than %60 of epilepsy has associated with mitochondrial (mt) dysfunction. Ketogenic diet (KD) has been used in the treatment of epilepsy since the 1920s. Aim. To evaluate the evidence behind KD in mt dysfunction in epilepsy. Methods. Databases PubMed, Google Scholar and MEDLINE were searched in an umbrella approach to 12 March 2021 in English. To identify relevant studies specific search strategies were devised for the following topics: (1) mitochondrial dysfunction (2) epilepsy (3) KD treatment. Results. From 1794 papers, 36 articles were included in analysis: 16 (%44.44) preclinical studies, 11 (%30.55) case reports, 9 (%25) clinical studies. In all the preclinic studies, KD regulated the number of mt profiles, transcripts of metabolic enzymes and encoding mt proteins, protected the mice against to seizures and had an anticonvulsant mechanism. Case reports and clinical trials have reported patients with good results in seizure control and mt functions, although not all of them give good results as well as preclinical. Conclusion. Healthcare institutions, researchers, neurologists, health promotion organizations, and dietitians should consider these results to improve KD programs and disease outcomes for mt dysfunction in epilepsy.
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Levine, Arie, Wael El-Matary, and Johan Van Limbergen. "A Case-Based Approach to New Directions in Dietary Therapy of Crohn’s Disease: Food for Thought." Nutrients 12, no. 3 (2020): 880. http://dx.doi.org/10.3390/nu12030880.
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Recent evidence has demonstrated that Crohn’s disease may have its roots in dysbiosis of the microbiome and other environmental factors. One of the strongest risk factors linked to immune activation appears to be diet. Exclusion diets have been shown to ameliorate inflammation and induce remission in 70–80% of treatment-naïve children at disease onset, and to induce remission in patients that lose response or are refractory to currently recommended medical therapy. Recent studies have also linked dietary modulation of the microbiome with clinical remission, while reintroduction of the previous habitual diet led to reactivation of inflammation and reversion of the dysbiotic state. While dietary therapy has usually been used as a first line therapy as a bridge to immunomodulators, newer insights suggest that new treatment paradigms involving dietary therapy may allow different treatment strategies. This case-based narrative review will discuss the Crohn’s disease exclusion diet (CDED) as monotherapy, combination therapy with drugs, as a rescue therapy in refractory patients and for de-escalation from medical therapy.
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S, Chiguer, Yousfi M, Mchachi A, et al. "Pan-Uveitis in Celiac Disease: A Case Report." Scholars Journal of Medical Case Reports 11, no. 02 (2023): 140–43. http://dx.doi.org/10.36347/sjmcr.2023.v11i02.011.
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Cealiac disease (CD) is an autoimmune disease, where autoantibodies (anti-transglutaminase (TG)2/anti- endomysial antibodies) attack mainly the intestinal tract. This disease is associated with several other autoimmune diseases. Ocular involvement in CD is often secondary to the intestinal malabsorption syndrome following the vitamin deficiency, so uveitis is rarely reported in the literature. We report the case of a 14-year-old girl, followed for coealiatic disease and type 1 diabetes, admitted for panuveitis of the left eye resistant to corticosteroid therapy, with a well response to a strict gluten-free diet. Uveitis secondary to coeliac disease is probably under-diagnosed, and some studies suggest the necessity to try a strict gluten-free diet in all idiopathic cortico-resistant uveitis.
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Sudrajat, Dedy G., and Hasan Maulahela. "A Case of Eosinophilic Gastritis with Gastric Bleeding." Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy 21, no. 3 (2020): 231–34. http://dx.doi.org/10.24871/2132020231-234.
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Eosinophilic gastritis is a manifestation of gastrointestinal eosinophilic disease. The clinical symptoms are not specific, similar to other gastric disease complaints. The diagnostic aproach aside from clinical manifestations is also from endoscopic and histopathological features as the gold standard. Management includes drugs and diet. In some cases with strictures and perforations, endoscopic or even surgical intervention needed. Steroid-based therapy, especially topical preparations, is still the main choice. Other alternative therapies such as immunosuppression and targeted therapy showed good results in several case reports and small-scale studies. Further research to get a better management needed, considering the prevalence of this disease is elevated.
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Ilaria, Proietti, Tolino Ersilia, Bernardini Nicoletta, et al. "The Role of the Western Diet on Atopic Dermatitis: Our Experience and Review of the Current Literature." Nutrients 15, no. 18 (2023): 3896. http://dx.doi.org/10.3390/nu15183896.
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The correlation between health and diet has always been a subject of interest in the field of dermatology and medicine in general. However, studies in the literature are still scarce, and need further investigation in the field of inflammatory skin diseases. In this paper, we report a case of a patient with atopic dermatitis whose complete recovery occurred only after combining dupilumab therapy with a Mediterranean diet regimen.
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Choi, James Sung Jun. "Diet-Based Interventions Against Cancer." Arbutus Review 11, no. 2 (2020): 22–30. http://dx.doi.org/10.18357/tar112202019612.
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Different diet-based approaches have been studied as potential adjuvants to standard cancer therapies in human clinical trials. However, these diets have been shown to have complications such as non-compliance and adverse side effects. This paper investigates four different types of diet-based approaches used in human clinical trials and compares their complications. The four diet-based approaches evaluated in this paper are ketogenic diet (KD), protein restriction, fasting and fasting mimicking diets (FMD), and combined interventions. Research shows that KDs have large reports of non-compliance from subjects, with subjects also experiencing significant weight loss, constipation, and fatigue. Protein restriction diets have greater levels of adherence from subjects but may lead to harmful hematological toxicities. Fasting and FMD showed greater adherence than subjects on KDs, and lower toxicities than subjects on protein restriction diets, but had a greater number of complaints of headaches, hunger, and dizziness. Finally, combined interventions have the fewest reports of side effects and non-compliance but suffer from a limited number of case studies. Given these results, diet-based interventions require further research to minimize side effects and non-compliance before becoming an accepted adjuvant to standard cancer therapy.
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Woo, Douglas A., Robert H. Collins, Howard S. Rossman, Olaf Stüve, and Elliot M. Frohman. "Mitoxantrone-Associated Leukemia in Multiple Sclerosis: Case Studies." International Journal of MS Care 10, no. 2 (2008): 41–46. http://dx.doi.org/10.7224/1537-2073-10.2.41.
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This article describes four new cases from our clinical practices of therapy-related acute leukemia after use of mitoxantrone in the treatment of patients with multiple sclerosis (MS) and reviews the mechanisms that predispose to this serious complication of treatment. The study consisted of a retrospective case series. Four previously unreported cases of secondary leukemia arising after mitoxantrone therapy in MS patients were identified, out of a combined cohort of 152 patients treated at our institutions. Three of the patients developed the acute promyelocytic leukemia subtype, after varying doses and latencies of mitoxantrone therapy. One of the study patients died. Characteristics of these patients and 10 previously reported cases are summarized. MS patients treated with mitoxantrone remain at risk for therapy-related leukemia, particularly acute promyelocytic leukemia. Strategies for minimization and prompt identification of this adverse event are needed.
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Green, Nicole, Talya Miller, David Suskind, and Dale Lee. "A Review of Dietary Therapy for IBD and a Vision for the Future." Nutrients 11, no. 5 (2019): 947. http://dx.doi.org/10.3390/nu11050947.
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Inflammatory bowel disease (IBD) is a chronic inflammatory condition affecting the gastrointestinal tract. The rising incidence of IBD has been associated with urbanization and shifts toward a Westernized diet. The intestinal microbiome has been a focus of disease pathogenesis and also therapeutic intervention. Dietary therapy for IBD has been well-studied with exclusive enteral nutrition, a formula-based diet with the exclusion of foods. In addition, interest in food-based exclusion diets has been increasing, with patients and families leading the charge. Challenges with dietary therapy for IBD include the lack of understanding of a detailed mechanistic pathway to explain the impact of diet on IBD pathogenesis and the difficult nature of designing and implementing dietary clinical trials. Epidemiological studies have demonstrated associations and intervention studies have demonstrated efficacy, but specific dietary targets remain as hypotheses at present. Current IBD therapy focuses on suppression of the immune system, yet the incomplete efficacy of present drugs suggests that other therapies must be developed and employed. Dietary interventions, with known ability to modulate the intestinal microbiome, are a unique opportunity to improve outcomes in IBD. Dietary intervention trials are challenging, and capturing both broad dietary patterns as well as exposure to individual food compounds is important. With increasing patient interest and preliminary research in dietary therapy indicating efficacy, it is imperative to further advance the science of utilizing diet in IBD, as well as to support patients by proactively addressing diet within their care plan.
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St-Jules, David E., Mary R. Rozga, Deepa Handu, and Juan Jesus Carrero. "Effect of Phosphate-Specific Diet Therapy on Phosphate Levels in Adults Undergoing Maintenance Hemodialysis." Clinical Journal of the American Society of Nephrology 16, no. 1 (2020): 107–20. http://dx.doi.org/10.2215/cjn.09360620.
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Background and objectivesHyperphosphatemia is a persistent problem in individuals undergoing maintenance hemodialysis, which may contribute to vascular and bone complications. In some dialysis centers, dietitians work with patients to help them manage serum phosphate. Given the regularity of hyperphosphatemia in this population and constraints on kidney dietitian time, the authors aimed to evaluate the evidence for this practice.Design, setting, participants, & measurementsThere was a systematic review and meta-analysis of clinical trials. MEDLINE, Embase, CINAHL, Web of Science, Cochrane Central Register of Controlled Trials, and other databases were searched for controlled trials published from January 2000 until November 2019 in the English language. Included studies were required to examine the effect of phosphate-specific diet therapy provided by a dietitian on serum phosphate in individuals on hemodialysis. Risk of bias and certainty of evidence were assessed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) method.ResultsOf the 8054 titles/abstracts identified, 168 articles were reviewed, and 12 clinical trials (11 randomized, one nonrandomized) were included. Diet therapy reduced serum phosphate compared with controls in all studies, reaching statistical significance in eight studies, although overall certainty of evidence was low, primarily due to randomization issues and deviations from protocol. Monthly diet therapy (20–30 minutes) significantly lowered serum phosphate in patients with persistent hyperphosphatemia for 4–6 months, without compromising nutrition status (mean difference, −0.87 mg/dl; 95% confidence interval, −1.40 to −0.33 mg/dl), but appeared unlikely to maintain these effects if discontinued. Unfortunately, trials were too varied in design, setting, and approach to appropriately pool in meta-analysis, and were too limited in number to evaluate the timing, dose, and strategy of phosphate-specific diet therapy.ConclusionsThere is low-quality evidence that monthly diet therapy by a dietitian appears to be a safe and efficacious treatment for persistent hyperphosphatemia in patients on HD.
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Turcan, Svetlana, and Liudmila Tofan-Scutaru. "Nutrition therapy in acute and chronic pancreatitis." Medicine and Pharmacy Reports 94, no. 3 (2022): S51—S55. http://dx.doi.org/10.15386/mpr-2515.
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Pancreatitis is an inflammatory disease associated with disorders of nutrient assimilation and, as a result, with significant changes in the nutritional status.
 All patients with acute pancreatitis should be considered at nutritional risk and should be screened using validated screening methods. The optimal nutritional treatment for acute pancreatitis has been debated for decades. The traditional approach was "nothing in the mouth", only parenteral nutrition until the acute symptoms disappear and the level of serum pancreatic enzymes decreases. However, this tactic can contribute to various complications, starting with malnutrition and ending with sepsis due to damage of the intestinal mucosa. Clinical trials and meta-analyses have shown that patients with acute pancreatitis can tolerate oral nutrition and that oral / enteral nutrition is associated with a shorter hospital stay and a lower rate of complications compared to solely parenteral. Therefore, early oral nutrition with a low-fat "soft food" is recommended. In case of oral feeding intolerance, enteral nutrition is preferable, but not parenteral supply. A combination of enteral and parenteral nutrition may be recommended in patients who do not tolerate a sufficient amount of enteral nutrition.
 Malnutrition in chronic pancreatitis cannot be detected using BMI alone, and a detailed nutritional assessment is required, including assessment of symptoms and organic functions, anthropometry, and biochemical tests. Nutritional therapy in chronic pancreatitis should be multifactorial and based on abstinence from alcohol and nicotine, and diet modification. International guidelines no longer recommend severe dietary fat restriction; on the contrary, a physiological diet is recommended, but with adequate replacement of pancreatic enzymes. In case of intolerance to physiological nutrition, a low-fat diet with oral nutritional supplements is recommended to replenish energy and nutrients.
 This is a review of recent studies and guidelines on nutrition in pancreatitis for physicians and medical trainees.
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Marenych, Nadiia, and Janice L. Gilden. "A Case Report of Euglycemic Diabetic Ketoacidosis in the Setting of Keto Diet and SGLT-2 Inhibitors." Journal of the Endocrine Society 5, Supplement_1 (2021): A360. http://dx.doi.org/10.1210/jendso/bvab048.733.
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Abstract Background: Euglycemic diabetic ketoacidosis is relatively uncommon. Studies of SGLT inhibitors, when added to either insulin pumps or multiple daily injections have shown glycemic benefit in type 1 diabetes mellitus (DM), with reductions of Hba1c, body weight, glucose variability, without increased hypoglycemia, but with increase of DKA. We report a case of euglycemic diabetic ketoacidosis in a patient with type 1 DM, precipitated by keto diet and SGLT-2 inhibitor use. Clinical Case: A 24 year-old female with 17 years of type 1DM, using insulin pump therapy and empagliflozin, started a keto diet, then stopped meal time boluses, and eventually turned off her pump. Urine ketones were high. After 12 hours, she developed fatigue, nausea, abdominal pain, and shortness of breath, and presented to the emergency room. She was afebrile with BP 112/68, HR 123 beats/minute, respiratory rate 18, and oxygen saturation on room air 99%. Physical exam: anxious in mild distress, abdomen was diffusely tender without guarding. Laboratory results: sodium 141 mmol/L, potassium 5.3 mmol/L, chloride 103 mmol/L, CO2 8 mmol/L, Anion gap 30 mmol/L, with blood glucose of 201 mg/dL,and BUN 22 mg/dL, creatinine 1.55 mg/dL, GFR 41 ml/min/1.73m, Hba1c 7.2%, Normal thyroid tests, WBC 23.1 10x3/ul, Hgb 16.6 g/dl, HCT 53.3%, normal differential, Urine: ketones >=80 mg/dl, Protein 30 mg/dl, urine glucose >500 mg/dl. CT abdomen and pelvis with contrast: questionable regional colitis of ascending colon with prominent distended stomach, and possible functional obstruction, such as diabetic gastroparesis, and fatty infiltration of liver. An insulin infusion per DKA protocol was started. Over the next few days, she continued with high anion gap and low CO2; requiring bicarbonate drip. By day 3, laboratory results finally improved. Symptoms completely resolved, and the patient was started on a carbohydrate restricted diet with insulin pump therapy, and discharged home after intensive education by the diabetes team. Discussion: Euglycemic diabetic ketoacidosis is a rare, but serious complication of DM, characterized by glucose values ≤200 mg/L, ketosis and metabolic acidosis. Possible risk factors include decreased caloric intake, keto diet, heavy alcohol consumption, change in insulin regimen, chronic liver disease, pregnancy, and sodium glucose cotransporter 2 (SGLT2) inhibitors. This case highlights the complex interplay between type 1 DM, a keto diet, in combination with SGLT-2 inhibitor therapy, which may result in euglycemic diabetic ketoacidosis, and also demonstrates the importance of patient education regarding risks of ketoacidosis in the setting of SGLT-2 inhibitor therapy, in conjunction with low calorie intake and diets, such as the keto diet. Reference: (1) Julio Rosenstock, et al. Empagliflozin as Adjunctive to Insulin Therapy in Type 1 Diabetes: The EASE Trials. Diabetes Care 2018 Dec; 41(12): 2560–2569.
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Putra Gofur, Nanda Rachmad, Aisyah Rachmadani Putri Gofur, Soesilaningtyas Soesilaningtyas, Rizki Nur Rachman Putra Gofur, Mega Kahdina, and Hernalia Martadila Putri. "Lifestyle Modification Therapy in Diabetes Disease: A Review Article." Endocrinology and Disorders 6, no. 1 (2022): 01–03. http://dx.doi.org/10.31579/2640-1045/112.
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Introduction: Diabetes mellitus (DM) is a metabolic disease characterized by high blood glucose levels (hyperglycemia) resulting from disturbances in insulin secretion, insulin action or both. Insulin is a hormone produced by pancreatic beta cells, which is needed to utilize glucose from digested food. Comprehensive care is taken to treat patients with either prediabetes or diabetes. Diabetes management includes lifestyle interventions along with pharmacologic therapy and routine blood glucose monitoring. So that a decrease in blood glucose can occur and can be stable for a long time. Discussion:Lifestyle modification is an economical treatment that saves costs to prevent or delay the onset of diabetes. On the other hand, nutritional management provided by a dietitian is also recommended. Moderate weight loss goals are an important component of diabetes prevention and treatment, as large body weight can increase blood glucose levels, and can also have an increasing impact on blood pressure and cholesterol levels. Weight loss can be achieved through a balanced diet, with total control of calories and free carbohydrates. However, for diabetic patients following a low-carbohydrate diet, they should be informed about possible side effects such as hypoglycemia, headaches and constipation. Other studies have suggested the consumption of complex dietary fiber and whole grains to improve blood sugar control. Greater adherence to diet combined with light physical activity was associated with a lower likelihood of diabetes after adjusting for various factors. Conclusion:Lifestyle modification is a fairly cost-effective treatment to prevent or delay the onset of diabetes, with a risk reduction of about 58% in 3 years. It is strongly recommended by the ADA that patients with IGT, IFG or HbA1C levels of 5.7-6.4% be counseled on lifestyle changes such as diet and exercise. On the other hand, nutritional management provided by a dietitian is also recommended.
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Mazurek, Aleksandra, Damian Machaj, Jakub Polak, et al. "The role of diet and supplementation in the prevention and treatment of autism spectrum disorders." Journal of Education, Health and Sport 26, no. 1 (2023): 11–16. http://dx.doi.org/10.12775/jehs.2023.26.01.001.
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The role of diet and supplementation in the prevention and treatment of autism spectrum disorders There is evidence indicating the positive effects of dietary intervention in the prevention and treatment of autism spectrum disorders. There are studies linking maternal vitamin D deficiency with ASD in offspring. Children and adolescents on the autism spectrum are also supposed to have significantly lower concentrations of vitamin D than healthy children and adolescents. This indicates the role of vitamin D supplementation in the prevention and treatment of ASD(5). Diets most commonly used in the therapy of autism spectrum disorders are: dairy-free and gluten-free, specific carbohydrate diet, low phenol, low oxalate and ketogenic diet(4). The most popular of them are dairy-free and gluten-free. However, studies conducted by Dr. James Adams attribute the highest effectiveness to a diet of specific carbohydrates(7). After applying the ketogenic diet, improvements in concentration, learning ability and social behavior were observed(1,26). However, it should be remembered that the scientific literature contains a small number of reliably conducted studies confirming the effectiveness of individual diets and supplementation in the prevention and treatment of ASD. Therefore, the positive impact of dietary intervention is still referred to as "potential". In addition, the use of certain diets may be associated with side effects, such as vomiting and hypoglycemia in the case of a ketogenic diet (1,28) and underweight in the case of elimination diets(16). Therefore, the introduction of dietary changes for therapeutic purposes should be carried out under the constant supervision of doctors and dieticians.
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Tan, Jocelyn Lai, Jennifer Carrick, Vida Almario Passero, et al. "Modified ketogenic diet in solid tumors: A Veteran Affairs Pittsburgh Healthcare System case series." Journal of Clinical Oncology 37, no. 15_suppl (2019): e14217-e14217. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.e14217.
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e14217 Background: Cancers prefer glucose due to mitochondrial dysfunction. Ketogenic diets fuel normal cells while starving cancer. Sparse data exists on ketogenic diets in solid tumors. Methods: Studied 5 advanced solid tumor patients on a modified ketogenic diet plus standard of care chemotherapy. Daily carbohydrate limited to 20-40 grams, no sweets or starch. Histories and clinical courses are presented. Results: Case 1: 70 year old male, medically inoperable Stage IIIA poorly differentiated squamous cell lung cancer and non-hodgkins lymphoma. Treated with radiation and paclitaxel/carboplatin. After 5 months, lung cancer relapsed in a neck mass, treated with chemoradiation plus the diet. At 46 months, scans and blood counts were normal. Case 2: 42 year old, 417 lb. male diabetic stage IV colon cancer, spread to lungs and liver. Progressed on 5FU/bevacizumab/oxaliplatin, irinotecan, tipiracil/trifluridine, regorafenib but responded to 5FU/irinotecan rechallenge plus liver chemoembolization. Dieted, mild ketosis but lost 64 lbs, stable disease at 6.5 years. Case 3: 42 year old male, Stage III BRAF V600 E melanoma, Vemurafenib intolerant. Bulky axillary nodes resected plus diet for 3 years. Complete remission at 7 yrs 9 months. Case 4: 57 year old male, medically inoperable liver cancer, normal AFP values and normal scans after 5 months of sorafenib. AFP later increased to 690 ng/ml. Advised to change treatment but he refused and started the ketogenic diet with the sorafenib. After 5 months, AFP improved to 445 ng/ml. Sorafenib and diet interrupted for 3 months, AFP rose to 1017. At 7 yrs, 4 months, back on sorafenib and diet, AFP 1520 mg/ml, negative scans. Case 5: 49 year old male, aggressive digital papillary skin adenocarcinoma, multi-organ metastases. Had side-effects with many chemotherapies (paclitaxel/bevacizumab/carboplatin, sorafenib, gemcitabine, oxaliplatin/5FU, cyclophosphamide) Stable disease on diet despite multiple therapy changes. At 34 months, he was off the diet, tumors grew plus new brain lesions (resected). Alive on atezolizumab at 36 months. Conclusions: Ketogenic diets in human solid tumors seem well tolerated and may improve response and survival after standard therapy.
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Nurul Hakim, Ruliany Yuni, Didik Tamtomo, and Bhisma Murti. "Effect of Gluten Free Casein Free Diet on Maladaptive Behavior in Autistic Children: Meta-Analysis." Indonesian Journal of Medicine 8, no. 3 (2023): 286–94. http://dx.doi.org/10.26911/theijmed.2023.08.03.06.
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Background: Children with Autism tend to experience gastrointestinal disorders more often. Interactions between the gut and brain microbiome influence mood and behavior in health and disease. Diet therapy, specifically the gluten and case-free diet (GFCF) is an elimination diet that involves removing certain proteins from the normal diet, such as gluten and casein. The right intervention can change behavior for the better and through the right handling. This study aims to estimate the effect of a case-free gluten-free diet on maladaptive behavior in autistic children, through a meta-analysis of primary studies conducted by previous authors. Subjects and Method: This study is a systematic review and meta-analysis with the following PICO, population: Autism children, intervention: gluten-free case-free diet, comparison: no case-free gluten-free diet, outcome: maladaptive behavior. The articles used in this study were obtained from three databases, namely PubMed, Google Scholar, and Science Direct, using the search key “Diet Gluten Free Casein Free” OR “NonDiet Gluten Free Casein Free” OR “GFCF” AND “Autism” OR “Autism” AND “Maladaptive” AND “Randomize Controlled Trial” OR “RCT”. The included article is a full-text Randomized Controlled Trial study designed from 2002 to 2022 and reports the mean and SD in multivariate analysis. The selection of articles is done using PRISMA flow diagrams. Articles were analyzed using the Review Manager 5.4 application. Results: A total of 7 randomized controlled trial studies conducted in the Americas, Europe, and Asia were selected for meta-analysis. Autistic children who received casein-free gluten-free had an average score of 0.11 units of maladaptive behavior lower than those who were not given a diet (SMD= 0.11 95% CI= .035 to 0.13; p= 0.360). Conclusion: The casein-free gluten-free diet has an effect on reducing the risk of maladaptive behavior in children with autism. Keywords: casein free gluten-free diet, gfcf, maladaptive behavior, autism Correspondence: Ruliany Yuni Nurul Hakim. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A Surakarta 57126, Central Java, Indonesia. Email: Ruliany27@gmail.com. Ponsel +6282124886320. Indonesian Journal of Medicine (2023), 08(03): 286294
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Ghitea, Timea Claudia. "Correlation of Periodontal Bacteria with Chronic Inflammation Present in Patients with Metabolic Syndrome." Biomedicines 9, no. 11 (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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Shukenbaeva, Regina A., and Tatiana V. Turti. "Modern Treatment Principles for Children with Primary Intestinal Lymphangiectasia: Observational Studies Systematic Review." Pediatric pharmacology 19, no. 1 (2022): 72–77. http://dx.doi.org/10.15690/pf.v19i1.2377.
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Background. Primary intestinal lymphangiectasia (PIL) is severe and rare disease with poor prognosis. Its management is complex due to the lack of clinical guidelines (both Russian and international). Therefore, consideration of modern principles of this pathology treatment is still crucial, it also can improve the quality and life expectancy in these patients.Objective. The aim of the study is to schematize and unify all relevant data on PIL cases over the past 10 years, to identify modern treatment principles for provision of timely medical car. Methods. Systematic review of publications from 2011 to 2021 in PubMed database was performed. Clinical cases, observational studies, and literature reviews were included.Results. Nutrition therapy in the treatment of PIL has many advantages and it is the firstline therapy. However, modern medicine allows to help children with this pathology via somatostatin group drugs, immunosuppressants, and surgery in case of insufficient nutrition correction.Conclusion. Primary intestinal lymphangiectasia has certain scientific interest in pediatricians and gastroenterologists’ practice. Understanding of the disease, its early diagnosis and pathological process localization allow us to choose the correct diet, to determine the need for surgical intervention, and to prescribe targeted drug therapy.
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Fila, Michal, Cezary Chojnacki, Jan Chojnacki, and Janusz Blasiak. "Is an “Epigenetic Diet” for Migraines Justified? The Case of Folate and DNA Methylation." Nutrients 11, no. 11 (2019): 2763. http://dx.doi.org/10.3390/nu11112763.
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Migraines are a common disease with limited treatment options and some dietary factors are recognized to trigger headaches. Although migraine pathogenesis is not completely known, aberrant DNA methylation has been reported to be associated with its occurrence. Folate, an essential micronutrient involved in one-carbon metabolism and DNA methylation, was shown to have beneficial effects on migraines. Moreover, the variability of the methylenetetrahydrofolate reductase gene, important in both folate metabolism and migraine pathogenesis, modulates the beneficial effects of folate for migraines. Therefore, migraine could be targeted by a folate-rich, DNA methylation-directed diet, but there are no data showing that beneficial effects of folate consumption result from its epigenetic action. Furthermore, contrary to epigenetic drugs, epigenetic diets contain many compounds, some yet unidentified, with poorly known or completely unknown potential to interfere with the epigenetic action of the main dietary components. The application of epigenetic diets for migraines and other diseases requires its personalization to the epigenetic profile of a patient, which is largely unknown. Results obtained so far do not warrant the recommendation of any epigenetic diet as effective in migraine prevention and therapy. Further studies including a folate-rich diet fortified with valproic acid, another modifier of epigenetic profile effective in migraine prophylaxis, may help to clarify this issue.
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Brauer, Paula M., Rhona M. Hanning, Jose F. Arocha, et al. "Development of a Nutrition Counselling Care Map For Dyslipidemia." Canadian Journal of Dietetic Practice and Research 68, no. 4 (2007): 183–92. http://dx.doi.org/10.3148/68.4.2007.183.
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Purpose: Care maps or clinical pathways for nutrition therapy of dyslipidemia could add to current practice guidelines, by providing templates for feasible and recommended diet counselling processes. A care map was therefore developed by engaging expert and generalist dietitians and external experts from across Canada in a multi-stage consensus process. Methods: First, a qualitative study was undertaken with a convenience sample of 12 practitioners to identify possible diet care options, using hypothetical client scenarios and cognitive analysis. Second, these care options were rated for five case scenarios considered typical (overweight clients, with or without clinical cardiovascular disease and other comorbidities, potentially motivated to change, consuming high-fat diets, and facing various major barriers to eating behaviour change). The rating was conducted through a survey of participants. Highly appropriate, recommended, and feasible options for counselling were ranked through a two-round modified Delphi process, with teleconference discussions between rounds. Results: Forty-nine professionals started the consensus process; 39 (80%) completed all aspects. Numerous care processes were appropriate for all clients, with additional focus on barriers for low-income clients, sodium intake for clients with hypertension, and smoking cessation in smokers. Conclusions: The resulting care map, “Dietitians’ Quick Reference Guide for Clinical Nutrition Therapy for Overweight Clients with Dyslipidemia,” provides a basis for current practice and new effectiveness studies.
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Wingralek, Zuzanna Joanna, Paweł Miś, Hubert Wróblewski, Aleksandra Zimna, and Joanna Rog. "The importance of anti-inflammatory diet in depression: a literature review and recommendations." Current Problems of Psychiatry 24 (July 20, 2023): 134–50. http://dx.doi.org/10.12923/2353-8627/2023-0013.
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Introduction: The etiopathogenesis of depression consists of genetic, metabolic, hormonal and psychogenic factors. The pathological process increases the risk and worsens the course of the disorder in chronic low-grade inflammation. Nutrition affects the pro-/anti-inflammatory state, and an anti-inflammatory diet is a proposed form supporting the therapy of inflammatory diseases. The review aimed to determine the importance of an anti-inflammatory diet in supporting the treatment of mood disorders. Materials and methods: The available literature was reviewed by searching the PubMed and Google Scholar databases using the following keywords: nutritional psychiatry, depression, anti-inflammatory diet from the inception to 10th February 2023. We characterized the anti-inflammatory diet, potential mechanisms of action, the epidemiological and intervention studies conducted so far focusing on this topic, as well as barriers to implementation and potentially harmful effects of its implementation. Results: Observational studies show a link between the anti-inflammatory potential of diet and a lower risk of developing mood disorders. The pro-inflammatory profile of the diet is associated with higher severity of depressive symptoms. On the other hand, an anti-inflammatory diet has a beneficial effect on the brain-gut axis and the intestinal microbiota, which are involved in the development of depressive disorders. Conclusions: It is necessary to increase clinical practitioners' and patients' knowledge of the impact of nutrition on mental health. Our team developed recommendations for an anti-inflammatory diet adapted to Polish conditions based on the guidelines. In the case of patients' barriers to implementation, encouraging partial implementation of the recommendations is advised.
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Ravi, Preethi, Lakshmi Shanmuga Sundaram, and Kundavi Shankar. "Interventions for gestational diabetes: impact of assisted reproduction." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 10, no. 5 (2021): 1878. http://dx.doi.org/10.18203/2320-1770.ijrcog20211505.
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Background: This study was to assess whether assisted conception acts as a predictor for insulin therapy in gestational diabetes (GDM) treatment. The secondary aim of this study was to analyse the type of interventions that aided control of blood glucose. The role of ART as a risk factor that increases the risk of insulin therapy in GDM remains elusive. Many studies have established the increased association of GDM with ART conceptions. Factors like advanced maternal age, polycystic ovarian syndrome or obesity that increase GDM risk also contribute to subfertility. Increased level of Hb A1C, elevated FBS values are considered as risk factors for antenatal insulin therapy in women with GDM. This study was to assess if assisted reproduction is an independent variable associated with insulin therapy.Methods: In this retrospective study, GDM was diagnosed by fasting blood sugar and 2 hours postprandial or 75 gms OGTT based on IADPSG criteria with FBS >90, 2hr >140. Among the 121 GDM mothers, 42 women were ART conceptions and 79 were spontaneous conceptions. The entire study population (121) was divided into 3 groups based on the treatment required. Diet and lifestyle modifications only, diet and life style modifications with OHA and OHA with or without insulin therapy. The demographic, clinical, biochemical data were compared between groups. Details were obtained from case notes and entered in an excel sheet and SSPS software was used for statistical analysis. Inclusion criteria was all GDM pregnancies in the study period (4 years; January 2014 to December 2017) for whom case notes were available. Exclusion criteria was women with diabetes prior to pregnancy, those who moved elsewhere for delivery and multiple gestations.Results: There was no difference in the insulin requirement between ART conception and spontaneous conceptions. Out of 121 women, 34 women (28%) required diet and life style management, 38 women required OHA (31%), 49 women required insulin (40%). 73% of women who were managed with diet were spontaneous conceptions. Preterm labor was the commonest complication encountered (17%). ART women had more number of perinatal complications, in all treatment groups.Conclusions: ART was not a predictor for insulin therapy in this study group. The largest group of intervention for GDM was with insulin, 40%. Perinatal complications were seen more in ART mothers with GDM compared with spontaneous conceptions. Spontaneous conceptions women had more percentage of management with diet and life style modifications.
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Shbarou, Rolla M., Rose Mary Boustany, Rose T. Daher, Parisa Pakdel, Abir Noureddine, and Pascale E. Karam. "Outcome of Nonketotic Hyperglycinemia in Lebanon: 14-Year Retrospective Review." Neuropediatrics 50, no. 04 (2019): 235–43. http://dx.doi.org/10.1055/s-0039-1692207.
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Nonketotic hyperglycinemia is a rare inborn error of glycine metabolism characterized by a severe metabolic encephalopathy with drug-resistant seizures. Here, we report the outcome of nonketotic hyperglycinemia in a cohort of patients diagnosed and followed-up at a tertiary care reference center in Lebanon, between 2000 and 2014.Eight out of 12 patients with nonketotic hyperglycinemia were retrospectively reviewed. The remainders were excluded for incomplete data. The majority of cases presented with seizures and hypsarrhythmia or burst suppression patterns. Half of the patients died. Survival varied between 7 days and 18 years. Seizures remained unresponsive with poor outcome, despite standard supportive care and antiepileptic therapy; however, two patients were responsive to ketogenic diet and one of them became seizure-free.Scarce data on the outcome of nonketotic hyperglycinemia patients from the Middle East and North Africa region are available. The ketogenic diet, in combination with standard therapies, appears to be effective in controlling the seizures in this devastating disorder. Larger multicenter studies are still needed to establish the role of the ketogenic diet in nonketotic hyperglycinemia.
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Dieterich, Walburga, and Yurdagül Zopf. "Gluten and FODMAPS—Sense of a Restriction/When Is Restriction Necessary?" Nutrients 11, no. 8 (2019): 1957. http://dx.doi.org/10.3390/nu11081957.
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Gluten-free diet (GFD) is enjoying increasingly popularity, although gluten-free products are considerably more expensive. GFD is absolutely necessary for patients with celiac disease, as in this case even minor amounts of gluten can lead to the destruction of the intestinal mucosa. In addition, GFD is currently the best therapy to improve clinical symptoms of patients with non-celiac gluten sensitivity (NCGS), although the diet may not be as strict as that for patients with celiac disease. Beside gluten, other wheat components such as oligosaccharides and amylase trypsin inhibitors are discussed as triggers of NCGS in this review. An overlap between gastrointestinal symptoms in NCGS and irritable bowel syndrome (IBS) is described. Patients with NCGS attribute their symptoms to the consumption of gluten, while patients with IBS rarely describe gluten as a trigger. Recently, several studies have demonstrated that the introduction of a low FODMAP (fermentable oligo-, di-, monosaccharides, and polyols) diet reduced gastrointestinal symptoms in patients with IBS and this diet is suggested as the first choice of therapy in IBS. However, a low FODMAP diet also eliminates prebiotica and may negatively influence the gut microbiota. For this reason, the diet should be liberalized after symptom improvement. There is no evidence that a GFD is healthier than the standard diet. In contrast, GFD often is accompanied by nutritional deficiencies, mainly minerals and vitamins. Therefore, GFD and low FODMAP diets are not recommended for healthy subjects. Since wheat contains fructans belonging to FODMAPs), a GFD is not only gluten-free but also has less FODMAPs. Thus, symptom improvement cannot be correctly correlated with the reduction of either one or the other.
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Asha, S. A., and M. B. Kavita. "The Impact of Barley-based diet on Diabetes: A Case-Report." Journal of Complementary and Alternative Medical Research 23, no. 2 (2023): 36–40. http://dx.doi.org/10.9734/jocamr/2023/v23i2480.
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Background: Diabetes is becoming more prevalent in India. The increase in prevalence in most populations has probably been driven by modifiable risk factors, including lack of exercise and an increasing prevalence of overweight/obesity and unhealthy diets and habits. Yava(Barley)is one among the food articles and its preparation is extensively suggested in Prameha(Diabetes) and other lifestyle disorders. Diet intervention is the primary and effective way to control sugar levels. Diet therapy without much alteration of one’s habits will be acceptable to individuals. A barley-based diet is formulated and evaluated for its effectiveness in the case of diabetics.
 Aim: To study the effectiveness of a Yava-based diet on fasting and postprandial blood sugars, fasting and postprandial urine sugars and lipid profile. 
 Study Design: Modified crossover study
 Place and Duration of the Study: Department of Swasthavritta, Sri Dharmasthala Manjunatheshwara College of Ayurveda and Hospital, Hassan, between December 2022 and February 2023.
 Methodology: A single case study was designed and a barley-based diet was planned as a flatbread, suggested for a month as a dietetic intervention along with the routine dietary habit. The diabetic subject was screened in the outpatient department. Laboratory investigations were carried out at one-month intervals three times. Subject studied for observation period and intervention period with the follow-ups. 
 Results: There were decreases in blood sugar and urine sugar levels and in lipid profile. Symptoms like polyphagia, heaviness in the body are also reduced.
 Conclusion: Ayurveda literature opines Prameha is a disease of vitiated Kapha and fat tissue. Yava has the properties of pacifying Kapha and fat. The diet plan acts as a potential antidiabetic food. Yava can be an alternative to other grains and more beneficial for diabetes.
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Baranzini, Sergio E. "Insights into microbiome research 1: How to choose appropriate controls for a microbiome study in MS?" Multiple Sclerosis Journal 24, no. 10 (2018): 1278–79. http://dx.doi.org/10.1177/1352458518788967.
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Microbiome studies are on the rise, but appropriate measures must be taken into account to reduce potential confounders that could obscure results. Among these are diet, age, sex, geography, and even the presence of house pets. In the particular case of multiple sclerosis (MS), the influence of disease-modifying therapy must also be considered. Thus, selecting an appropriate group of controls can substantially increase the statistical power of a microbiome study. Furthermore, given the enormous complexity and volatility of the microbiome, this could be the deciding factor between reporting signal and simply noise.
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Wickman, Brooke E., Byambaa Enkhmaa, Ronit Ridberg, et al. "Dietary Management of Heart Failure: DASH Diet and Precision Nutrition Perspectives." Nutrients 13, no. 12 (2021): 4424. http://dx.doi.org/10.3390/nu13124424.
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Heart failure (HF) is a major health care burden increasing in prevalence over time. Effective, evidence-based interventions for HF prevention and management are needed to improve patient longevity, symptom control, and quality of life. Dietary Approaches to Stop Hypertension (DASH) diet interventions can have a positive impact for HF patients. However, the absence of a consensus for comprehensive dietary guidelines and for pragmatic evidence limits the ability of health care providers to implement clinical recommendations. The refinement of medical nutrition therapy through precision nutrition approaches has the potential to reduce the burden of HF, improve clinical care, and meet the needs of diverse patients. The aim of this review is to summarize current evidence related to HF dietary recommendations including DASH diet nutritional interventions and to develop initial recommendations for DASH diet implementation in outpatient HF management. Articles involving human studies were obtained using the following search terms: Dietary Approaches to Stop Hypertension (DASH diet), diet pattern, diet, metabolism, and heart failure. Only full-text articles written in English were included in this review. As DASH nutritional interventions have been proposed, limitations of these studies are the small sample size and non-randomization of interventions, leading to less reliable evidence. Randomized controlled interventions are needed to offer definitive evidence related to the use of the DASH diet in HF management.
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Filardi, Tiziana, Francesca Panimolle, Clara Crescioli, Andrea Lenzi, and Susanna Morano. "Gestational Diabetes Mellitus: The Impact of Carbohydrate Quality in Diet." Nutrients 11, no. 7 (2019): 1549. http://dx.doi.org/10.3390/nu11071549.
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Gestational diabetes mellitus (GDM) is defined as “glucose intolerance that is first diagnosed during pregnancy”. Mothers with GDM and their infants may experience both short and long term complications. Dietary intervention is the first therapeutic strategy. If good glycaemic control is not achieved, insulin therapy is recommended. There is no consensus on which nutritional approach should be used in GDM. In the last few years, there has been growing evidence of the benefits of a low glycaemic index (LGI) diet on diabetes and cardiovascular disease. The effect of a LGI diet on GDM incidence has been investigated as well. Several studies observed a lower incidence of GDM in LGI diet arms, without adverse maternal and fetal outcomes. The main positive effect of the LGI diet was the reduction of 2-h post-prandial glucose (PPG). Several studies have also evaluated the effect of the LGI diet in GDM treatment. Overall, the LGI diet might have beneficial effects on certain outcomes, such as 2-h PPG, fasting plasma glucose and lipid profile in patients with GDM. Indeed, most studies observed a significant reduction in insulin requirement. Overall, according to current evidence, the LGI nutritional approach is safe and it might therefore be considered in clinical care for GDM.
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Oshlianska, O. A., O. M. Okhotnikova, and L. V. Kvashnina. "On the question of nutrition of children with rheumatic diseases." Modern pediatrics. Ukraine, no. 3(123) (April 30, 2022): 66–72. http://dx.doi.org/10.15574/sp.2022.123.66.
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The article presents data from recent studies on the influence of active components of food and diet on the course of rheumatic diseases, it was discussed the main current recommendations for patient nutrition. It has been shown that nutrition does not have a proven direct effect on the course of rheumatic diseases in children, which is why without standardized drug therapy can not prescribe any diet, but by increasing the variety of foods and their overall harmonization, the doctor's recommended diet reduce the manifestations of comorbid conditions or side effects of treatment. In children with rheumatic pathology who have lesions of the visceral organs (heart, liver, kidneys), the diet should be used in accordance with the guidelines for the treatment of relevant pathological conditions. Similarly, only patients with a proven deficiency of vitamins (including vitamin D) should be prescribed the necessary drugs in accordance with the relevant guidelines. In the case of a combination of such disorders, it is advisable to individualize the diet with the involvement of a professional nutritionist. Pediatric patients with rheumatic diseases and their parents should be informed by a physician about the importance of a healthy diet that meets the age requirements and includes a variety of foods high in grains, fruits and vegetables, low in saturated fat, moderate in sugar, but complete removal of any -what foods from the diet is impractical. No conflict of interests was declared by the authors. Key words: diet, children, rheumatic diseases.
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Luster, Markus, and Christoph Reiners. "Radioiodine Therapy in Differentiated Thyroid Cancer." World Journal of Endocrine Surgery 1, no. 1 (2009): 7–12. http://dx.doi.org/10.5005/jp-journals-10002-1002.
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ABSTRACT For many years the recommended therapy for differentiated thyroid carcinoma (DTC), with the exception of unifocal papillary carcinoma <1 cm in diameter, has consisted of (near) total thyroidectomy followed by postoperative radioiodine ablation of thyroid remnant tissue. Even though results from randomized controlled trials are still missing, this combination has proven its worth as a safe and very effective treatment that resulted in an improved life expectancy and reduced recurrence rate for DTC patients in many observational studies. Preparation for I-131 ablation using standard activities between 1-3 GBq requires low iodine diet for 2-3 weeks and TSH-stimulation by withdrawal of thyroid hormone medication for 3 weeks following thyroidectomy or by use of recombinant human TSH alternatively. The advantages of exogenous TSH stimulation are a maintained quality of life and a lower radiation dose to the remainder of the body. In case of metastastic spread, higher activities of radioiodine in the range of 4-11 GBq are necessary; if possible, individual dosimetry is recommended. The standard approach for preparation of I-131 therapy in patients with metastases is endogenous hypothyroidism after thyroid hormone withdrawal. Indications, contraindications and practical aspects of radioiodine treatment will be discussed in this review.
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Zaiken, Kathy, and Kalindi D. Raval. "Treatment of Hypercholesterolemia in Pregnancy: Risks versus Benefits." Journal of Pharmacy Technology 21, no. 5 (2005): 258–61. http://dx.doi.org/10.1177/875512250502100504.
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Objective: To identify treatment options for hypercholesterolemia in pregnant women. Data Sources: A search was conducted of MEDLINE (1966–March 2004), EMBASE (1980–March 2004), and International Pharmaceutical Abstracts (1970–March 2004). Key terms included fibric acid derivatives, plant stanol/sterols, niacin, ezetimibe, vitamin E, LDL-apheresis, and fish oil. Study Selection and Data Extraction: The articles evaluated described hypercholesterolemia during pregnancy and lipid therapy options. Data Synthesis: Elevated lipid levels in pregnant women may have a negative impact on the fetus. Case reports and clinical trials from 1966 to March 2004 were evaluated for information regarding the impact of various cholesterol-lowering agents on both the mother and fetus. These case reports and trials conclude that additional studies are needed to determine their overall safety in pregnant women. Conclusions: Lipid-lowering therapies have differing levels of safety and efficacy and are not well studied in pregnant women. Therefore, a diet low in cholesterol and fat is the recommended treatment for hypercholesterolemia during pregnancy.
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Koss-Mikołajczyk, Izabela, Vanja Todorovic, Sladjana Sobajic, et al. "Natural Products Counteracting Cardiotoxicity during Cancer Chemotherapy: The Special Case of Doxorubicin, a Comprehensive Review." International Journal of Molecular Sciences 22, no. 18 (2021): 10037. http://dx.doi.org/10.3390/ijms221810037.
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Cardiotoxicity is a frequent undesirable phenomenon observed during oncological treatment that limits the therapeutic dose of antitumor drugs and thus may decrease the effectiveness of cancer eradication. Almost all antitumor drugs exhibit toxic properties towards cardiac muscle. One of the underlying causes of cardiotoxicity is the stimulation of oxidative stress by chemotherapy. This suggests that an appropriately designed diet or dietary supplements based on edible plants rich in antioxidants could decrease the toxicity of antitumor drugs and diminish the risk of cardiac failure. This comprehensive review compares the cardioprotective efficacy of edible plant extracts and foodborne phytochemicals whose beneficial activity was demonstrated in various models in vivo and in vitro. The studies selected for this review concentrated on a therapy frequently applied in cancer, anthracycline antibiotic—doxorubicin—as the oxidative stress- and cardiotoxicity-inducing agent.
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de Souza Bosco Paiva, Caroline, and Maria Helena Melo Lima. "Introducing a very low carbohydrate diet for a child with type 1 diabetes." British Journal of Nursing 28, no. 15 (2019): 1015–19. http://dx.doi.org/10.12968/bjon.2019.28.15.1015.
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Type 1 diabetes mellitus is a serious autoimmune disease for which no cure is available. The treatment includes insulin therapy, carbohydrate counting, eating healthy foods, exercising regularly, and maintaining a healthy weight. The goal is to keep blood glucose levels close to normal most of the time to delay or prevent complications. Despite the increase in the use of insulin pumps and continuous glucose monitors in recent years, the management of type 1 diabetes remains suboptimal in terms of glycaemic control and normal glycated haemoglobin (HbA1c) level. This article discusses the case of a child with type 1 diabetes who was successfully treated with a very low-carbohydrate diet, resulting in normal levels of HbA1c and normal blood glucose 95% of the time in a range of 70–180 mg/dL (4.0 mmol/L−10 mmol/L). Therefore, further studies are needed to verify how a very low carbohydrate diet impacts child development.
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Di Rosa, Claudia, Annamaria Altomare, Elena Imperia, Chiara Spiezia, Yeganeh Manon Khazrai, and Michele Pier Luca Guarino. "The Role of Dietary Fibers in the Management of IBD Symptoms." Nutrients 14, no. 22 (2022): 4775. http://dx.doi.org/10.3390/nu14224775.
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Inflammatory bowel diseases (IBDs) are chronic, progressive, immune-mediated diseases of the intestinal tract. The main subtypes of IBDs are Chron’s disease (CD) and ulcerative colitis (UC). The etiology is still unclear, but there are genetic, environmental and host-related factors that contribute to the development of these diseases. Recent literature has shown that dietary therapy is the cornerstone of IBD treatment in terms of management of symptoms, relapse and care of the pathology. IBD patients show that microbiota dysbiosis and diet, especially dietary fiber, can modulate its composition. These patients are more at risk of energy protein malnutrition than the general population and are deficient in micronutrients. So far, no dietary component is considered responsible for IBD and there is not a specific therapeutic diet for it. The aim of this review is to evaluate the role of dietary fibers in CD and UC and help health professionals in the nutritional management of these pathologies. Further studies are necessary to determine the appropriate amount and type of fiber to suggest in the case of IBD to ameliorate psychosocial conditions and patients’ quality of life.
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Epure, Alina, Veronica Anastasoi, and Dan Mircea Cheta. "Correlation between the presence of metals with intoxication potential, omega 3 deficiency, increased omega 6:omega 3 ratio and their associated symptoms." Romanian Medical Journal 69, no. 2 (2022): 72–79. http://dx.doi.org/10.37897/rmj.2022.2.5.
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Objectives. The study aims to determine the correlation between the presence of heavy metals with intoxication potential (mercury, aluminum, arsenic), increasing the values for the omega 6: omega 3 ratio, decreasing the concentration of omega 3 and it’s impact on health. Another objective of this study is the use of an integrated protocol, developed by an interdisciplinary team, based on a customized alignment program and a treatment plan. Materials and methods. We evaluated in a retrospective observational study, 77 patients who came to the Nutribalance Clinic between September 2017 and December 2019, with specific symptoms of intoxication with toxic metals, especially mercury, aluminum, arsenic and omega 3 deficiencies. The manifested symptoms required a complete set of blood tests for each subject in the study group, tests that showed the presence of one, two and three toxic metals in the case of all 77 subjects. The interdisciplinary team developed a personalized treatment and diet plan, monitoring the evolution on the symptoms initially manifested by each subject. Outcomes. The results of this study shows the beneficial impact of the personalized diet plan and supplements used on the decrease in omega 6:omega 3 ratio, the significant increases in omega 3 which support the detoxification process of heavy metals and a significant improvement in the symptoms of each patient. Conclusions. This study reveals that the process of chelating or detoxifying heavy metals is a complex one and that implies the presence of a complementarity between food and nutritional supplement therapy, avoiding one single direction, as results can be obtained for a short or insignificant period of time.
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Arsa, Sri Asmawati, Armanto Makmun, and Paulus Paulus. "Case Report: Grade II Hypertension Accompanied by Obesity with Consumption of Propolis Herbs." Journal La Medihealtico 5, no. 3 (2024): 562–71. http://dx.doi.org/10.37899/journallamedihealtico.v5i3.1362.
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Hypertension is often said to be a silent killer, because it is a deadly disease without being accompanied by symptoms first as a warning for the victim. Hypertension with the incidence of obesity is still common. The prevalence of hypertension accompanied by obesity also continues to increase. According to some studies, obesity and hypertension have a meaningful relationship. One alternative treatment that can be an option to lower blood pressure is herbal therapy. Herbal medicine is classified as complementary medicine is a phenomenon that appears today among many other non-conventional treatment phenomena, such as treatment with herbs or herbal therapy, acupuncture, and cupping. The use of herbs is one of the alternative treatments chosen by the community other than conventional (medical) treatment.One of the natural products produced is propolis. Propolis is one of the natural products produced by bees and is widely used as a medicine or supplement, anti-inflammatory, disease treatment, accelerating wound healing, and others. The patient in this case is a woman with the age of 50 years. Patients come with complaints of dizziness, headache and low back pain accompanied by a history of hypertension, and obesity. The patient was diagnosed with Grade 2 Hypertension on Treatment, and Obesity was given therapy in the form of Amlodipine 10 mg 1x1, Paracetamol 500 mg 3x1 and Vitamin B Complex 2x1.Hypertension suffered by patients is hypertension obtained due to several predisposing factors in patients, namely diet, obesity, age, and gender.
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Hasmira, Hasmira, Budi Anna Keliat, and Giur Hargiana. "Application of Family Psychoeducation to Client Psychosocial Disorder Anxiety and Body Image Due." Jurnal Keperawatan Jiwa 8, no. 4 (2020): 485. http://dx.doi.org/10.26714/jkj.8.4.2020.485-490.
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Diabetes mellitus is a metabolic disease that is becoming poses a threat to global health and requires special attention. The prevalence of Diabetes mellitus has increased significantly throughout the world in the last 10 years. Indonesia ranks sixth among people with diabetes worldwide. Anxiety and body image are of the psychosocial effects given from Diabetes mellitus. Anxiety and body image can affect the client’s diet, causing changes in nutrition. Through case report by providing family psychoeducation therapy in the form of stress management that can reduce and even overcome anxiety and body image is very useful for clients and families to reduce the risk of body image for clients who experience nutritional imbalances and family body image that treats clients with Diabetes mellitus. This study aims help to overcome anxiety and body image disorders in diabetes mellitus clients so that diabetes mellitus clients have a good appetite. In addition, families are also able to cope with stress in treating diabetes mellitus clients. Research using case studies shows that clients already have a good appetite, anxiety and impaired body image can be lowered and the family is able to cope with stress and able to treat clients with diabetes mellitus. Family psychoeducation therapy is very useful in reducing the level of anxiety and disruption of the body image of a diabetes mellitus client in supporting the client’s diet and being able to deal with family stress in caring for a diabetes mellitus client.
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Ragimov, M. R., D. D. Omelchuk, L. I. Ibragimova, O. S. Derevyanko, and T. V. Nikonova. "Slowly evolving, immune-mediated diabetes in 14-year-old patient: a case report." Diabetes mellitus 24, no. 1 (2021): 70–73. http://dx.doi.org/10.14341/dm12397.
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Slowly developing immune-mediated diabetes, often called latent autoimmune diabetes in adults, is characterized by the presence of autoantibodies (ATs) to glutamic acid decarboxylase (GADA), the patient's age at the onset over 35 years, and the absence of the need for insulin therapy for 6-12 months to 6 years from the moment of diagnosis, according to the WHO classification of 2019, refers to hybrid forms of diabetes mellitus (DM). In this article, we present a case history of slowly developing immune-mediated diabetes in a 14-year-old boy who was transferred from metformin monotherapy and a diet with restriction of digestible carbohydrates to the intensified insulin therapy only 4 years after the onset of diabetes mellitus with a glycated hemoglobin (HbA1c) level of less than 6.5% throughout the disease. As a result of the studies, the patient was found to have a homozygous genotype highly predisposing to the development of Type 1 Diabetes Mellitus (T1DM), as well as increased levels of ATs to GADA and tyrosine phosphatase (IA-2A). The initially preserved level of basal C-peptide and the clinical course of the disease in this patient do not allow us to classify this case as a classic variant of the course of Type 1 Diabetes Mellitus.
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Razak, Adil, and Abdul Aziez Isaacs. "Implementation and evaluation of a weight-reduction programme for diabetic patients at a primary health care facility in the Western Cape: a pilot study." South African Family Practice 59, no. 2 (2017): 34. http://dx.doi.org/10.4102/safp.v59i6.4637.
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Background: Diabetes is a common non-communicable disease and complications are resulting in increased disability, reduced life expectancy and enormous health costs for virtually every society. Medical Nutrition Therapy is important for the prevention, treatment, and self-management of diabetes, and the prevention or delay in onset of diabetes-related complications. The current nutritional guidelines for diabetes state that carbohydrates should comprise 45–60% of the total nutritional intake and that lowcarbohydrate or high-protein diets offer no long-term success over healthy eating plans. Recent studies suggest that there may be merit in using low-carbohydrate diets in diabetic patients for weight reduction and improved cardiovascular markers. This study aimed to implement and evaluate a pilot programme for weight loss in diabetes mellitus type 2 patients by comparing a low-carbohydrate diet with the conventional low-fat diet.
 
 Methods: The study design was that of a two-group parallel design, with one group following a low-fat diet and the other a low-carbohydrate diet. Diabetic patients attending the Mitchell’s Plain Community Health Centre in Cape Town were recruited, with 10 participants in each group. Both groups received similar advice on exercise and behaviour change. Changes in weight, waist circumference, blood pressure and blood parameters (creatinine, lipids and HbA1c) were recorded at baseline and again after 12 weeks.
 
 Results: There were reductions in weight (1.85 kg vs. 0.1 kg gain) and HbA1c (1.72 vs. 0.32) in the low-carbohydrate diet group when compared with the low-fat diet group. No significant change was seen in other parameters including BP, total cholesterol and serum creatinine for either group.
 
 Conclusion: Low-carbohydrate diets may be effective in promoting weight loss and improving glucose control in diabetic patients. Implementation of this programme would require a paradigm shift for staff and further studies to assess its acceptability for patients.
 
 (Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp)
 
 S Afr Fam Pract 2017; DOI: 10.1080/20786190.2017.1329490
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Zapata Laguado, M. I., A. Luna-Meza, D. Gonzalez Hurtado, and L. Aya Ramos. "P17.11.A Experience of ketogenic diet with support of liquid formula 3:1 and high-grade gliomas: Case series." Neuro-Oncology 24, Supplement_2 (2022): ii91. http://dx.doi.org/10.1093/neuonc/noac174.319.
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Abstract Background High-grade gliomas, including glioblastoma, are the most common primary malignant brain tumors in adults. Despite the efforts to develop new therapies, treatment options remain limited and the prognosis is poor. Ketogenic diet, is an emerging complementary therapy for high-grade gliomas. It is hypothesized that through the change of the energy source from glucose to ketones and the inability of glioma cells to metabolize ketone bodies with the same ease due to inefficient oxidative phosphorylation, tumor growth is slowed. The feasibility of a ketogenic diet is a matter of concern. Its influence on the quality of life of patients with advanced cancers showing that even though it may cause constipation and reflux, quality of life is generally not affected Material and Methods We reported a case series of patients with high-grade gliomas using ketogenic diet with liquid formula 3:1 ratio (KDS) as a complementary treatment. We describe baseline characteristics, and EORTC-QLQ30 score and symptom evaluation Results We describe the case of 3 patients (2 women and 1 man) with diagnoses of grade 4 glioblastoma (2) and grade 3 oligodendroglioma (1), mean age 46.7 years (38- 56 years), ECOG 1 (2) and ECOG2 (1), gross tumor resection (1 glioblastoma patient), subtotal resection (1 glioblastoma patient), and biopsy (1 oligodendroglioma patient). All patients received radiotherapy, 66.7% (n=2) stupp protocol, and 33.3% (n=1) received hypofractionated therapy and adjuvant treatment with temozolomide. All patients received first line with temozolomide, and 33.3% received a total of four lines of chemotherapy. All the patients were fed orally and managed with KDS at the last progression. Median follow up time was 4 months. KDS didn’t impact corporal weight and a positive impact was noted in seizure episodes (&gt; 3 per day before vs &lt; 3 per day after DKS) and quality of life (EORTC-QLQ30 61,3 [60 - 66,8] at the begining vs 70,9 [69,8 - 71,2] at the last visit). Regarding tolerance, one patient presented diarrhea and/or constipation grade 1 the first 5 days of treatment. Compliance was measured by days with a median adherence of 90%. Current disease status is stable disease (RANO criteria) in the three patients. Conclusion KDS could be an interesting therapy complementary to standard treatment in patients with high grade gliomas, especially in those patients who debut with seizures, improving quality of life and number of convulsive crises. More studies in adult patients are required to confirm this hypothesis
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Khosroshahi, Hamid Tayebi, and Kamyar Kalantar-zadeh. "Dialysis Free Protocol for Some End Stage Renal Disease Patients (Khosroshahi Protocol)." Functional Foods in Health and Disease 2, no. 8 (2012): 300. http://dx.doi.org/10.31989/ffhd.v2i8.104.
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Background: The number of patients with End Stage Renal Disease (ESRD) is growing annually around the world. Provision of renal replacement therapy in the form of dialysis and transplant is relatively expensive. Recent studies have shown no survival benefit of early initiation of dialysis. Given recent outcome data of the timing of dialysis treatment and the expenses and logistics of hemodialysis procedure have stimulated research on alternative strategies. The aim of this study is to introduce another type of renal replacement therapy for selective patients with advanced chronic kidney disease (CKD).Methods: In a case series we used a so-called “dialysis free protocol” consisting of a low protein diet, uremic toxin adsorbents, and prebiotics for selective ESRD patients who had dialysis access constraints or did not agree placement of hemodialysis vascular access or peritoneal dialysis catheter. Findings: clinical and biochemical results of this study showed that these patients were not deteriorating during the study period and Blood Urea Nitrogen (Bun) & serum creatinin levels were not elevated in these months. Participating patients were relatively well throughout the study without signs of florid uremia and without a need for emergent or urgent dialysis. Conclusion: We conclude that our proposed dialysis free protocol reduces the need for dialysis treatment at least transiently. Whether this protocol can reduce the need for dialysis treatment requires additional studies. Key words: End Stage Renal Disease, Low Protein Diet, Prebiotics, Activated Charcoal
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Zuckerman, Diana. "Hype in Health Reporting: “Checkbook Science” Buys Distortion of Medical News." International Journal of Health Services 33, no. 2 (2003): 383–89. http://dx.doi.org/10.2190/pmm9-dput-hn3y-lmjq.
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The greatest danger to public health might be “checkbook science”: research intended not to expand knowledge or to benefit humanity but to sell products. Much of the media coverage of health news stories is based on public relations efforts on behalf of the companies that sell the products, including pharmaceutical companies, diet clinics, or doctors selling new techniques. The author presents three case studies of how companies selling medical products effectively but invisibly shaped recent news coverage of medical products: fen-phen diet pills, breast implants, and hormone replacement therapy. All involve subtle strategies whereby physicians and other experts paid by corporate interests are influential because they are perceived to be objective medical experts. Articles in prestigious medical journals are sometimes ghostwritten by individuals paid by companies or are based on biased analyses or interpretations shaped by corporate interests. Nonprofit organizations that tout the benefits of specific medical products also may be part of the public relations efforts of the companies making the product. Meanwhile, important newsworthy studies are ignored by the mass media when corporate interests do not publicize or pitch the results to influential reporters and producers.
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Takkavatakarn, Kullaya, Piyawan Kittiskulnam, Khajohn Tiranathanagul, et al. "The role of once-weekly online hemodiafiltration with low protein diet for initiation of renal replacement therapy: A case series." International Journal of Artificial Organs 44, no. 11 (2021): 900–905. http://dx.doi.org/10.1177/03913988211049815.
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Incremental hemodialysis (HD) has become an exciting approach according to the recognition of the importance of preserving residual kidney function (RKF). However, not all incident HD patients are suitable for this approach, particularly once-weekly HD. This is the first study which reported the effectiveness of once-weekly online-hemodiafiltration (OL-HDF) plus low protein diet (LPD) in incident HD patients. All stage 5 CKD patients who had chosen HD as their treatment modality at the HD center of King Chulalongkorn Memorial Hospital, Bangkok, Thailand, with RKF ⩾ 3 mL/min calculated by renal clearance of urea and urine output ⩾ 800 mL/day, started the treatment with once-weekly OL-HDF. Dietitians advised patients to consume LPD (0.6–0.8 g/kg/day) on non-dialysis days and a regular protein diet on the dialysis day (1.2 g/kg/day). Eleven incident HD patients were enrolled in the study. The mean RKF and urine volume at baseline were 4.56 ± 2.21 mL/min and 2,019.54 ± 743.73 mL/day, respectively. After 6 and 12 months of follow-up, the mean RKF of the patients who remained in the once-weekly OL-HDF protocol were 3.82 ± 1.68 mL/min and 3.28 ± 0.95 mL/min, respectively. The median duration of once-weekly OL-HDF before transitioning to twice- or thrice-weekly OL-HDF was 7 months (3–24 months). The most common indication for stepping prescription was too low RKF. We reported that dialysis initiation in the university-based center with once-weekly OL-HDF in carefully selected incident HD patients combined with LPD under serial monitoring is practical. Further studies on the clinical benefits of once-weekly OL-HDF are still required.
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Lonsdale, Derrick, Raymond J. Shamberger, and Mark E. Obrenovich. "Dysautonomia in Autism Spectrum Disorder: Case Reports of a Family with Review of the Literature." Autism Research and Treatment 2011 (2011): 1–7. http://dx.doi.org/10.1155/2011/129795.
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Case histories of a mother and her two children are reported. The mother was a recovered alcoholic. She and her two children, both of whom had symptoms that are typical of autistic spectrum disorder, had dysautonomia. All had intermittently abnormal erythrocyte transketolase studies indicating abnormal thiamine pyrophosphate homeostasis. Both children had unusual concentrations of urinary arsenic. All had symptomatic improvement with diet restriction and supplementary vitamin therapy but quickly relapsed after ingestion of sugar, milk, or wheat. The stress of a heavy metal burden, superimposed on existing genetic or epigenetic risk factors, may be important in the etiology of autism spectrum disorder when in combination. Dysautonomia has been associated with several diseases, including autism, without a common etiology. It is hypothesized that oxidative stress results in loss of cellular energy and causes retardation of hard wiring of the brain in infancy, affecting limbic system control of the autonomic nervous system.
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Malik, Fahad, Prasanna Wickremesinghe, and Jessie Saverimuttu. "Case report and literature review of auto-brewery syndrome: probably an underdiagnosed medical condition." BMJ Open Gastroenterology 6, no. 1 (2019): e000325. http://dx.doi.org/10.1136/bmjgast-2019-000325.
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Auto-brewery syndrome (ABS), also known as gut fermentation syndrome, is a rarely diagnosed medical condition in which the ingestion of carbohydrates results in endogenous alcohol production. The patient in this case report had fungal yeast forms in the upper small bowel and cecum, which likely fermented carbohydrates to alcohol. Treatment with antifungal agents allowed subsequent ingestion of carbohydrates without symptoms. He had been exposed to a prolonged course of antibiotics before this occurred. We postulate that the antibiotic altered his gut microbiome, allowing fungal growth. This diagnosis should be considered in any patient with positive manifestations of alcohol toxicity who denies alcohol ingestion. The aim of this case report was confirmation and treatment of ABS using a standardised carbohydrate challenge test followed by upper and lower endoscopy to obtain intestinal secretions to detect fungal growth. These fungi were speciated and antifungal sensitivity performed. This allowed the use of appropriate therapy. The patient was kept on a carbohydrate-free diet during the initial 6-week period of therapy. A single-strain probiotic for competitive inhibition of fungal growth was given to the patient. This probiotic was later replaced by a multistrain bacterial probiotic hoping that the multiple bacteria would inhibit fungi better than a single-strain. The beneficial role of probiotics in this condition has not been studied. The patient was rechallenged for endogenous alcohol production prior to reintroducing carbohydrates in his diet.
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Romanchuk, A. A., and O. M. Okhotnikova. "Features of differential diagnosis of inflammatory intestinal disease with food allergy in children of breast age." Modern pediatrics. Ukraine, no. 4(124) (May 30, 2022): 79–83. http://dx.doi.org/10.15574/sp.2022.124.79.
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Inflammatory bowel disease (IBD) is a chronic inflammatory disease that affects the gastrointestinal tract and includes ulcerative colitis (ulcerative colitis) and Crohn's disease. Symptoms often include abdominal pain, weight loss, hematochezia, and diarrhea, although some patients may experience more insidious gastrointestinal and extraintestinal manifestations. Allergic proctocolitis caused by dietary protein (FPIAP) is a condition characterized by inflammatory changes in the distal parts of the colon in response to one or more foreign dietary proteins due to immune-mediated reactions. Clinically similar to IBD. Delay in the diagnosis of IBD, especially Crohn's disease, remains common in children, and potential complications due to these delays require effective differential diagnosis. Purpose - on the example of a clinical case to show the features of the differential diagnosis of IBD and FPIAP. Clinical case. Child A., 2 months old, has a green stool of liquid consistency, sometimes with mucus, abdominal pain. According to laboratory tests, high levels of fecal calprotectin and eosinophilic cationic protein were detected. Diet diagnostics in the form of an elimination diet and provocative tests were used. Due to which significant allergens have been identified and excluded from the mother’s diet. Conclusions. Determination of fecal calprotectin levels, fecal occult blood analysis, and serum IgE are important in the differential diagnosis of IBD and FPIAP. Timely diagnosis and rational therapy, prevents the development of severe consequences and improves the condition of patients. The research was carried out in accordance with the principles of the Helsinki declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors. Key words: inflammatory bowel disease, allergic proctocolitis, diet diagnostics, differential diagnosis, rectal bleeding.
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Tang, Meng, Qi Zhang, Kangping Zhang, Xi Zhang, and Hanping Shi. "Metabolism-Based Molecular Sub-Phenotyping Predict Ketogenic Diet Responses in Colorectal Cancer." Current Developments in Nutrition 4, Supplement_2 (2020): 356. http://dx.doi.org/10.1093/cdn/nzaa044_055.
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Abstract Objectives Current studies have confirmed that the sensitivity of the ketogenic diet (KD) therapy for cancer depends on the low expression of ketolytic enzymes. However, increasing evidence showed that heterogeneity of tumor metabolism leads to inconsistent efficacies of KD therapy, which broke the illusion of the possibility of cancer treatment. Our study aims to construct colon cancer metabolism-related molecular subtyping. Furthermore, to explore the metabolic heterogeneity in diverse colon cancer cells and illuminate the mechanisms of mitochondrial metabolic reprogramming. Thus, providing a theoretical basis for clinical nutritional therapy and combined intervention measures based on metabolic molecular phenotyping. Methods We selected 19 genes associated with glucose and the keto-body metabolic pathway, then constructed a prognostic gene signature by LASSO and KM curve. Based on the screened metabolic molecules, we further explored the nutrition metabolic heterogeneity and illuminate our understanding of mitochondrial metabolic reprogramming under nutritional stress in vivo. Results Through the integration of patients’ transcriptomics data, we stratified colon cancer patients into three significant phenotypes with distinct glycolytic and ketolytic characteristics. We identified glycolysis + subtype with either GLUT1 or PFKFB3 overexpression, and ketolysis + subtype with either OXCT1 or ACAT1 deficiency. In general, combining glycolysis+/ketolysis-phenotype demonstrated the worst prognosis. Furthermore, we discovered the metabolic heterogeneity through western blot and energy metabolic phenotype analysis which also confirmed that these different colon cancer cells showed great significance in metabolic reprogramming under nutritional stress. Conclusions The multi-target combination of metabolic phenotyping proved to be a foundation for individualized molecular stratified treatment which plays an essential role in predicting effectiveness of nutritional modulation therapy among colon cancer patients. It provided a theoretical basis for the clinical trial of KD therapy for patients with specific metabolic subtypes of colon cancer. Funding Sources The National Key Research and Development Program: The key technology of palliative care and nursing for cancer patients.
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Sinesi, Antonia, Giovanni Di Leo, Savino Cefola, Ruggiero Damato, and Cinzia Casu. "Using Extra Virgin Olive Oil (Evoo) as a Therapy in Angular Cheilitis: Current Scientific Evidence is Rediscovering Our Grandparents’ Ancient Tradition." Journal of Dentistry, Oral Disorders & Therapy 9, no. 2 (2021): 1–6. http://dx.doi.org/10.15226/jdodt.2021.001126.
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Extra Virgin Olive Oil (EVOO) is an essential food in the Mediterranean diet. Since the last century, it was customary for people in southern Italy to use it to treat various diseases: burns, trauma, cheilitis and inflammatory processes of various kinds. Over time, this practice, the result of ancient knowledge handed down from generation by generation, gradually disappeared and was almost forgotten. In Southern Italy, precisely all through the countryside of the north of Bari in Apulia, is produced a particular type of EVOO from “Coratina” cultivar characterized by the presence of a high content of polyphenols and other biocoumponds, the highest compared to other cultivars. Although numerous studies on EVOO have shown its remarkable effectiveness in wound healing, no scientific studies have been proposed for the treatment of Angular Cheilitis(AC). In this case report, we propose the use of EVOO as a therapeutic aid in the treatment of AC not responsive to ointments of various kinds: cortisone, antibacterials or antifungals.
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Detopoulou, Paraskevi, and Vasilios Papamikos. "Gastrointestinal Bleeding After High Intake of Omega-3 Fatty Acids, Cortisone and Antibiotic Therapy: A Case Study." International Journal of Sport Nutrition and Exercise Metabolism 24, no. 3 (2014): 253–57. http://dx.doi.org/10.1123/ijsnem.2013-0204.
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Omega-3 fatty acids exert a plethora of physiological actions including triglycerides lowering, reduction of inflammatory indices, immunomodulation, anti- thrombotic effects and possibly promotion of exercise performance. Their use is widespread and for commonly ingested doses their side- effects are minimal. We report a case of a 60y amateur athlete who consumed about 20 g omega-3 fatty acids daily from supplements and natural sources for a year. After the intake of cortisone and antibiotics he presented duodenum ulcer and bleeding although he had no previous history of gastrointestinal problems. Although several animal data support gastro-protective effects of omega-3 fatty acids in the present case they were not able to prevent ulcer generation. The present observation may be explained by (i) the high dose of omega-3 fatty acids and their effect on bleeding, (ii) the fact that cortisone increases their oxidation and may render them proinflammatory, (iii) other antithrombotic microconstituents included in the consumed cod-oil and/or the diet of the subject and (iv) the differences in the coagulation and fibrinolytic systems of well- trained subjects. Further studies are needed to substantiate any possible interaction of cortisone and omega-3 fatty acids in wide ranges of intake.
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Bradshaw, Patrick C., William A. Seeds, Alexandra C. Miller, Vikrant R. Mahajan, and William M. Curtis. "COVID-19: Proposing a Ketone-Based Metabolic Therapy as a Treatment to Blunt the Cytokine Storm." Oxidative Medicine and Cellular Longevity 2020 (September 16, 2020): 1–34. http://dx.doi.org/10.1155/2020/6401341.
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Human SARS-CoV-2 infection is characterized by a high mortality rate due to some patients developing a large innate immune response associated with a cytokine storm and acute respiratory distress syndrome (ARDS). This is characterized at the molecular level by decreased energy metabolism, altered redox state, oxidative damage, and cell death. Therapies that increase levels of (R)-beta-hydroxybutyrate (R-BHB), such as the ketogenic diet or consuming exogenous ketones, should restore altered energy metabolism and redox state. R-BHB activates anti-inflammatory GPR109A signaling and inhibits the NLRP3 inflammasome and histone deacetylases, while a ketogenic diet has been shown to protect mice from influenza virus infection through a protective γδ T cell response and by increasing electron transport chain gene expression to restore energy metabolism. During a virus-induced cytokine storm, metabolic flexibility is compromised due to increased levels of reactive oxygen species (ROS) and reactive nitrogen species (RNS) that damage, downregulate, or inactivate many enzymes of central metabolism including the pyruvate dehydrogenase complex (PDC). This leads to an energy and redox crisis that decreases B and T cell proliferation and results in increased cytokine production and cell death. It is hypothesized that a moderately high-fat diet together with exogenous ketone supplementation at the first signs of respiratory distress will increase mitochondrial metabolism by bypassing the block at PDC. R-BHB-mediated restoration of nucleotide coenzyme ratios and redox state should decrease ROS and RNS to blunt the innate immune response and the associated cytokine storm, allowing the proliferation of cells responsible for adaptive immunity. Limitations of the proposed therapy include the following: it is unknown if human immune and lung cell functions are enhanced by ketosis, the risk of ketoacidosis must be assessed prior to initiating treatment, and permissive dietary fat and carbohydrate levels for exogenous ketones to boost immune function are not yet established. The third limitation could be addressed by studies with influenza-infected mice. A clinical study is warranted where COVID-19 patients consume a permissive diet combined with ketone ester to raise blood ketone levels to 1 to 2 mM with measured outcomes of symptom severity, length of infection, and case fatality rate.