Nutritional Evaluation Research Articles

117 Double Trouble: Rapunzel Syndrome Presenting with Closed-Loop Intestinal Obstruction Between Two Synchronous Trichobezoars

Abstract Background Trichobezoar formation is a rare phenomenon associated with certain psychiatric conditions like trichophagia and is more frequent in young women. Rapunzel Syndrome denotes a gastric trichobezoar which extends into the duodenum. We report a rare case of dual isolated trichobezoars, a gastric and an ileal trichobezoar, causing sub-acute closed-loop intestinal obstruction between the two bezoars. Case presentation A 15-years old girl presented to the emergency department with history of generalized abdominal pain and distention for two days. She had nausea, loss of appetite, absolute constipation followed by vomiting.She was tachycardiac, had abdominal distention with an ill-defined upper abdominal mass and absent bowel sounds. CT-scan abdomen revealed a giant trichobezor in stomach tailing into duodenum and a separate small rounded mass in ileum with dilated bowel loops. Mid-line laparotomy was done. Per-operatively a giant gastric trichobezoar(22x8cms) was extracted after gastrostomy, which completely occupied the stomach and extended into the duodenum. Another large ileal trichobezoar(6x5cms) was also removed via enterotomy at 2 feet proximal to the ileo-cecal junction. Hence a markedly distended closed loop was formed between the two obstructing trichobezoars. Enterotomies were closed using vicyrl2.0. Feeding was started on post-operative day-3 & she was discharged on day-5. She developed complete wound dehiscence after 2 weeks which was surgically closed. Patient was consulted for nutritional and psychiatric evaluation and for management of trichophagia. Conclusion Trichobezoars usually present with vague abdominal symptoms and can rarely cause intestinal obstruction. Invasive intervention such as laparoscopy or laparotomy becomes necessary for such large obstructing trichobezoars. Psychiatric follow-up and management are crucial to prevent its recurrence.

An Innovative Use of Propolis in the Production of Dipping Sauce Powder as a Functional Food to Mitigate Testicular Toxicity Induced by Cadmium Chloride: Technological and Biological Evidence.

Propolis is a common natural ingredient used in food production, food packaging, and pharmaceutical products. Therefore, the aim of our study was to prepare dipping sauce powders as an innovative functional product with a regular and spicy taste from economical raw materials with high nutritional value. The developed products were fortified with propolis powder at 250, 500, and 750 mg/kg. All studied dipping sauces were subjected to a palatability test, a nutritional evaluation, and a microbiological assay performed during 6 months of storage. In addition, an in vivo study was designed to evaluate the efficacy of these products in preventing the testicular toxicity disorders induced by cadmium chloride (CdCl2) in albino rats. Based on the palatability test, the dipping sauces supplemented with propolis at 250 mg/kg and 500 mg/kg were preferred. Moreover, all samples were safe to consume within 6 months. Biological results showed that all investigated propolis-enriched dipping sauce samples caused an improvement in all CdCl2-induced testicular histopathological and biochemical changes, especially the spicy dipping sauce powder fortified with 500 mg/kg of propolis.

Altı-12 Aylık Bebeklerin Anne Sütü ile Beslenme Durumlarının ve Tamamlayıcı Beslenme Uygulamalarının Değerlendirilmesi

Giriş: Yaşamın ilk yılı büyümenin en hızlı gerçekleştiği dönemdir. Anne sütü ile beslenme süresi ve tamamlayıcı beslenme uygulamaları, annelerin özelliklerine, ülkelere ve bölgelere göre farklılık gösterebilmektedir. Popülasyona özgü stratejiler geliştirmek için toplumun taranması ve değerlendirilmesi önemlidir. Amaç: Bu araştırma, 6-12 aylık bebeklerin anne sütü ile beslenme durumlarının ve tamamlayıcı beslenme uygulamalarının değerlendirilmesi amacıyla yapıldı. Yöntem: Tanımlayıcı ve kesitsel olarak planlanan bu araştırma, araştırmayı katılmayı kabul eden 536 anne-bebek çifti ile gerçekleştirildi. Verilerin toplanmasında anne ve bebeğe ait bilgilerin yer aldığı Kişisel Bilgi Formu kullanıldı. Bulgular: Tek başına anne sütü ile beslenme süresi 4,26 ± 1,97 ay olduğu saptandı. Tamamlayıcı beslenmeye ise 22,62 ± 2,79 haftada başlandığı bulundu. Lise ve lisans-lisansüstü mezunu annelerin ilkokul mezunu annelere kıyasla istatistiksel olarak daha uzun süre tek başına anne sütü verdikleri belirlendi (p < 0,05). Annelerin %86,5’inin bebeklerine ilk tamamlayıcı besin olarak yoğurt verdikleri, ilk bir yaş içerisinde bebeklerin %42,9’unun tuz, %20 ,8’inin şeker ve %14,7’sinin ise bal tükettikleri saptandı. Sonuç: Tamamlayıcı beslenmeye 6 aydan önce başlandığı, annelerin eğitim düzeyi arttıkça sadece anne sütü verme süresinin arttığı belirlendi. Annelerin bebek beslenmesindeki eksikliklerinin önlenmesinde, anne sütü ve tamamlayıcı beslenme konusundaki eğitimlerin arttırılmasının önemli olduğu düşünüldü. Annelere verilen eğitimlerin, annenin eğitim düzeyi göz önüne alı

Rates and determinants of fast chronic kidney disease progression distinguished by nutritional status, and the impact of malnutrition on mortality - evidence from a clinical population

Malnutrition is a serious problem that influences morbidity, mortality, functional activity, and quality of life in patients with chronic kidney disease (CKD). However, there has not been much research done on how nutritional status appears to affect mortality in non-dialysis CKD patients. This study aimed to recognize the rates and predictors of fast CKD progression distinguished by nutritional status, and also sought to determine the impact of malnutrition on mortality in non-dialysis CKD patients. This prospective cohort study (n=360) involved non-dialysis CKD patients with index estimated glomerular filtration rate (eGFR) between the range of 15-89ml/min/1.73m2. Nutritional status was evaluated by using the "Pt-Global web tool/PG-SGA". A loss of eGFR >4ml/min/1.73m2 per year was considered to be a sign of fast CKD progression. Kaplan-Meier plots were used to evaluate the cumulative survival, and Cox-proportional hazard models were used to analyze the renal outcomes. Around 244 (67.8%) of patients have experienced a fast decline in kidney function. In the malnourished group, systolic blood pressure and hyperphosphatemia were observed to have increased hazards for fast CKD progression. The overall incidence of mortality and composite endpoints were found to be 13.9% & 37.6%, respectively. Death rates (11.6%) and composite endpoints (29.8%) were higher in the malnourished (severe & moderate) group. Cox regression hazard model reported 4 times increased hazards for death [HR 4.41 (1.99-9.77) 95% CI; P≤0.005] and 3 times increased hazards for composite endpoints [HR 3.29 (2.10-5.16) 95% CI; P≤0.005] for 'severely malnourished' category in reference to 'normal nutrition' category. Fast CKD progression was observed to be more common in malnourished patients. Systolic blood pressure and hyperphosphatemia were recognized as potential predictors of fast CKD progression. Moreover, malnutrition was found to be a significant predictor of mortality among non-dialysis CKD patients. The findings of this study advocate for early nutritional evaluation and timely dietary interventions to halt the progression of CKD.

Selenium, Zinc, and Copper Status of Vegetarians and Vegans in Comparison to Omnivores in the Nutritional Evaluation (NuEva) Study.

Plant-based diets usually contain more nutrient-dense foods such as vegetables, legumes, whole grains, and fruits than a standard Western diet. Yet, the amount and especially the bioavailability of several nutrients, such as trace elements, is supposed to be lower in comparison to diets with consumption of animal-derived foods. Based on this, the Nutritional Evaluation (NuEva) study (172 participants) was initiated to compare the trace element status of omnivores, flexitarians, vegetarians, and vegans. Serum selenium, zinc, and copper concentrations and biomarkers were evaluated at baseline and during a 12-month intervention with energy- and nutrient-optimized menu plans. The implementation of optimized menu plans did not substantially influence the status of trace elements. At baseline, serum selenium biomarkers were lower in vegetarians and vegans compared to omnivores and flexitarians. The zinc intake of vegetarians and vegans was significantly lower compared to omnivores, whereas the Phytate Diet Score was increased. Accordingly, total serum zinc concentrations were reduced in vegans which was, however, only significant in women and was further supported by the analysis of free zinc. Regarding copper status, no differences were observed for total serum copper. Overall, we identified selenium and zinc as critical nutrients especially when maintaining a vegan diet.

Prognostic Nutritional Index (PNI) as a potential predictor and intervention target for perioperative ischemic stroke: a retrospective cohort study

BackgroundThe prognostic nutritional index (PNI) is a nutritional indicator and predictor of various diseases. However it is unclear whether PNI can be a predictor of perioperative ischemic stroke. This study aims to evaluate the association of the preoperative PNI and ischemic stroke in patients undergoing non-cardiac surgery.MethodsThe retrospective cohort study included patients who underwent noncardiac surgery between January 2008 and August 2019. The patients were divided into PNI ≥ 38.8 and PNI < 38.8 groups according to the cut-off value of PNI. Univariate and multivariate logistic regression analyses were performed to explore the association between PNI and perioperative ischemic stroke. Subsequently, propensity score matching (PSM) analysis was performed to eliminate the confounding factors of covariates and further validate the results. Subgroup analyses were completed to assess the predictive utility of PNI for perioperative ischemic stroke in different groups.ResultsAmongst 221,542 hospitalized patients enrolled, 485 (0.22%) experienced an ischemic stroke within 30 days of the surgery, 22.1% of patients were malnourished according to PNI < 38.8, and the occurrence of perioperative ischemic stroke was 0.34% (169/49055) in the PNI < 38.8 group. PNI < 38.8 was significantly associated with an increased incidence of perioperative ischemic stroke whether in univariate logistic regression analysis (OR = 1.884, 95% CI: 1.559—2.267, P < 0.001) or multivariate logistic regression analysis (OR = 1.306, 95% CI: 1.061—1.602, P = 0.011). After PSM analysis, the ORs of PNI < 38.8 group were 1.250 (95% CI: 1.000–1.556, P = 0.050) and 1.357 (95% CI: 1.077–1.704, P = 0.009) in univariate logistic regression analysis and multivariate logistic regression analysis respectively. The subgroup analysis indicated that reduced PNI was significantly associated to an increased risk of perioperative ischemic stroke in patients over 65 years old, ASA II, not taking aspirin before surgery, without a history of stroke, who had neurosurgery, non-emergency surgery, and were admitted to ICU after surgery.ConclusionsOur study indicates that low preoperative PNI is significantly associated with a higher incidence of ischemic stroke in patients undergoing non-cardiac surgery. Preoperative PNI, as a preoperative nutritional status evaluation index, is an independent risk factor useful to predict perioperative ischemic stroke risk, which could be used as an intervenable preoperative clinical biochemical index to reduce the incidence of perioperative ischemic stroke.

Nutritional Evaluation of Fishmeal Free Diets in European Seabass, Dicentrarchus labrax, Feeds Reared in Fresh Water

Nutritional Evaluation of Fishmeal Free Diets in European Seabass, Dicentrarchus labrax, Feeds Reared in Fresh Water

Treatment Approaches for Swallowing Disorders in Children.

A swallowing disorder or dysphagia is defined as a disorder in the sequence of swallowing, during the oral or pharyngeal phase, which compromises the safety and/or efficiency of transit of the food bolus to the esophagus. The evaluation of neurodevelopment, nutrition, and preventive medicine actions are as important as the clinical evaluation of dysphagia, so they must be included and systematized in all pediatric evaluations; This evaluation can be divided into different parts: bedside swallowing evaluation, instrumental swallowing evaluation, and additional studies. The management of swallowing disorders requires a multidisciplinary team approach, depending on the child's age, cognitive and physical abilities, and the specific swallowing and feeding disorder, ensuring adequate and safe nutrition and improving the patient's quality of life.

Optimization and Nutritional Evaluation of Non-Dairy Milk Blends

Optimization and Nutritional Evaluation of Non-Dairy Milk Blends

Food Security among Pregnant Women and Its Relationship with Body Mass Index in Eastern Iran

Background: Food insecurity is recognized as a serious public health problem worldwide. Since pregnant women are among the most vulnerable groups and their food insecurity may cause complications during pregnancy and on their newborns, the aim of this study is to investigate the relationship between food security and body mass index (BMI) of pregnant women in eastern Iran.&#x0D; Methods: This cross-sectional study was conducted on 335 pregnant women in 10 health centers in the east of Iran. Participants were selected by random cluster sampling. Data were collected using standard questionnaires including 18-item household food security survey module (HFSSM) designed by the U.S. Department of Agriculture (USDA) and nutritional evaluation forms.&#x0D; Results: The mean scores of the HFSSM of all pregnant women were 7.2±4.3. The household food security of pregnant women was significantly related to the occupation of spouses, mother's education, monthly salary, private home, and mother's age (P&lt;0.05). There was no significant relationship between food security and BMI (P=0.98).&#x0D; Conclusions: Based on the results, few people have food security. Pregnancy in older age, lower-income, and education affected the household food security. Appropriate strategies and policies are necessary to combat this problem.

Retrospective evaluation of the effect of nutritional status of patients with left ventricular assist device on clinical results in the postoperative period

Abstract Funding Acknowledgements Type of funding sources: None. Objective Malnutrition in patients undergoing left ventricular assist device (LVAD) implantation has negative consequences, such as infection and limited functional capacity. The effects of nutritional status of patients with LVAD on their clinical outcomes were investigated. Methods 116 records of patients with LVAD implantation were retrospectively analysed. For nutritional evaluation, nutrition risk score NRI score was calculated to divide the patients into two groups with and without malnutrition risk. Demographic and clinical data before LVAD, early postoperative adverse events after LVAD, prognostic data, and laboratory findings were analysed. Results 116 patients (6 females, 110 man) had a mean age of 60.5±9,46 years; Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) scores were determined as 1 (n=11), 2 (n=36), 3 (n=65), and 4 (n=4). Forty four patients (44%) (19 mild, 6 moderate, 19 severe) had MR. The MR was higher in patients with preoperative INTERMACS score 1, low level of haemoglobin and albumin The incidence of adverse events was found to be significantly higher in patients with higher preoperative grade NRI (death during the pooperative period, bleeding). Conclusion In the early postoperative period, a MR of 44% was detected in patients who underwent LVAD. Total 72.2 % patients had any adverse events. We found that the presence of MR was effective in predicting postoperative adverse events according to NRI score before LVAD treatment.

Optimized fortification of vitamin A&D2 in soymilk, characterization of the fortified soymilk and in vitro bioaccessibility studies of the fortificants

The study reports the fortification of vitamin A and D (fortificants) in soymilk (fortifying vehicle) by sustained emulsification, after previously encapsulating the two fortificants in emulsified form. The process parameters for fortification of the encapsulated fortificants into the fortifying vehicle were initially predicted by d-optimal mixture design and finally optimized through lab experimentations. Physico-chemical, nutritional and sensory evaluation of the fortified soymilk and in vitro bioaccessibility studies of the fortificants were performed. The optimized method of fortification for vitamin A and D2 in soymilk was successful with significant stability of the vitamin fortified soymilk with acceptable physico-chemical, nutritional parameters and sensory attributes. Fourier Transform Infrared Spectroscopy confirmed chemical compatibility between the vitamin fortificants and fortifying vehicle (soymilk). In vitro bioaccessibility studies showed good bioaccessibility of the two vitamin fortificants in soymilk.

Root pigmentation determines phytochemical, mineral, antioxidant and organoleptic attributes of Tunisian southern coastal carrot (Daucus carota subsp. sativus) landraces

Carrot (Daucus carota subsp. sativus) is a widely grown crop in temperate regions of the world, consumed by humans as an important source of nutrition. This study focused on five local varieties of carrots from irrigated regions of southern Tunisia (Sidi Sallem, Sagui, Arram, ElGrine and Boughrara) with different root pigmentation. The carrots were evaluated for their morphological, physicochemical, biochemical, and organoleptic characteristics. Morphological characterization showed significant differences (p<0.01) in length, weight, and diameter of the root part and aerial part among the five landraces. The pH, titratable acidity, and Brix values were also different for each landrace, ranging from 6.18 (Sagui) to 6.27 (Arram), 0.016 (Boughrara) to 0.045 mg.g − 1 citric acid (Arram), and 5.60 (Arram) to 7.80% (Sidi Sallem), respectively. The study also identified 10 phenolic acids through LC-ESI/MS analysis, with quinic acid, protocachuic acid, and chlorogenic acid being the most abundant compounds. The HPLC method was used to analyze the sugar and β-carotene contents of the landraces. Results showed that the Sidi Sallem landrace had the highest fructose (625 mg.kg−1 DM), glucose (1000 mg.kg−1 DM), and β-carotene (2551.808 mg. kg−1 DM) contents. Sagui had the highest levels of α-tocopherol (vitamin E) (236 μg. L − 1) and vitamin K2 (6.5 μg. L − 1). Sensory analysis of the juices and pureed salads prepared from the five carrot landraces confirmed the findings of the morphological and nutritional evaluations. This research suggests that a participatory breeding program should be considered to preserve genetic resources and improve them in terms of nutritional quality criteria. The work highlights the nutritional value of carrot as a source of natural antioxidant compounds, which may be beneficial in the food and pharmaceutical industries.

Chemical Composition, Antioxidant Potential, and Nutritional Evaluation of Cultivated Sorghum Grains: A Combined Experimental, Theoretical, and Multivariate Analysis.

Sorghum grain (Sorghum bicolor L. Moench) is a gluten-free cereal with excellent nutritional value and is a good source of antioxidants, including polyphenols, as well as minerals with proven health benefits. Herein, the phenolic composition, elemental profile, and antioxidant activity of sixteen food-grade sorghum grains (S1-S16) grown under agroecological conditions in Serbia were determined. Nine phenolic compounds characteristic of sorghum grains, such as luteolinidin, 5-methoxyluteolinidin, luteolidin derivative, luteolidin glucoside, apigeninidin, 7-methoxyapigeninidin, apigeninidin glucoside, and cyanidin derivative, were quantified. The antioxidant potential of the analyzed sorghum grains was evaluated by UV/Vis (DPPH, ABTS, and FRAP) and Electron Paramagnetic Resonance spectroscopy (hydroxyl and ascorbyl radical scavenging assays). The content of macro- and microelements was determined by Inductively Coupled Plasma Optical Emission spectroscopy. Theoretical daily intakes of selected major and trace elements were assessed and compared with the Recommended Daily Allowance or Adequate Intake. Sample S8 had the highest amount of phenolic compounds, while S4, S6, and S8 exhibited the strongest antioxidative potential. The sorghum studied could completely satisfy the daily needs of macro- (K, Mg, and P) and microelements (Se, Zn, Fe). Pattern recognition techniques confirmed the discrimination of samples based on phenolic profile and elemental analysis and recognized the main markers responsible for differences between the investigated samples. The reaction between hydroxyl radicals and luteolinidin/apigeninidin was investigated by Density Functional Theory and thermodynamically preferred mechanism was determined.

Lipid Composition Analysis and Characterization of Acyl Sterol Glycosides in Adzuki and Soybean Cultivars by Non-Targeted LC-MS.

Beans, a globally significant economic and nutritional food crop, are rich in polyphenolic chemicals with potential health advantages, providing high protein, fiber, minerals, and vitamins. However, studies on the global profiling of lipids in beans are limited. We applied a non-targeted lipidomic approach based on high-performance liquid chromatography coupled with linear ion trap-Orbitrap mass spectrometry (HPLC/LTQ-Orbitrap-MS) to comprehensively profile and compare the lipids in six distinct bean cultivars, namely, adzuki red beans-adzuki cultivar (ARB-AC), adzuki red beans-Benidainagon cultivar (ARB-BC), adzuki red beans-Erimoshouzu cultivar (ARB-EC), soybean-Fukuyutaka cultivar 2021 (SB-FC21), soybean-Fukuyutaka cultivar 2022 (SB-FC22), and soybean-Oosuzu cultivar (SB-OC). MS/MS analysis defined 144 molecular species from four main lipid groups. Multivariate principal component analysis indicated unique lipid compositions in the cultivars except for ARB-BC and ARB-EC. Evaluation of the concentrations of polyunsaturated fatty acid to saturated fatty acid ratio among all the cultivars showed that SB-FC21 and SB-FC22 had the highest value, suggesting they are the most beneficial for health. Furthermore, lipids such as acyl sterol glycosides were detected and characterized for the first time in these bean cultivars. Hierarchical cluster correlations revealed the predominance of ceramides in ARB-EC, lysophospholipids in SB-FC21, and glycerophospholipids in SB-OC. This study comprehensively investigated lipids and their compositions in beans, indicating their potential utility in the nutritional evaluation of beans as functional foods.

Hazelnut Skin Waste as a Functional Ingredient to Nutritionally Improve a Classic Shortbread Cookie Recipe.

Hazelnut skin (HS) is a byproduct of hazelnut processing (2.5% of total kernel) and becomes a food waste despite its high content of antioxidants, unsaturated fats, and fibers. Classic shortbread cookies have a large worldwide market, even if their nutritional composition does not meet nutritional guidelines due to the high content of saturated fats. In the present study, after the nutritional evaluation of four different HS varieties, 5% and 10% ratios of HS of the Tonda Gentile Romana variety were integrated into a classic shortbread cookie recipe, proportionally replacing the butter amount with the unsaturated fats naturally present in HS. The 10% HS addition determined a 20% increase in the monounsaturated oleic acid and a 15.7% decrease in the saturated palmitic acid, in addition to a significant ash increase. The sensory analysis revealed higher consumer acceptance of the 5% formulation, with scores comparable to the control. Although the 10% formulation obtained lower scores for consumer acceptance, 35% of the interviewed population said they would purchase it, indicating that this product, beyond the ethical dimension of using a food waste matrix to promote the circular economy, can attract the commercial interest of part of the population.

Association of Cardiovascular Disease in Patients with Mycosis Fungoides and Sézary Syndrome Compared with that in a Matched Control Cohort

Mycosis fungoides/Sézary syndrome (MF/SS) produces a low-grade chronic inflammatory state that may be associated with an increased risk of cardiovascular (CV) events, as seen in other chronic, systemic dermatologic diseases. To assess this association, a retrospective, cross-sectional study was designed in which 421 patients with a biopsy-proven diagnosis of MF/SS were compared with a control cohort of 4,210 age-, gender-, and race-matched patients randomly selected from the National Health and Nutritional Evaluation Survey database. The MF/SS cohort had a 14% prevalence of CV events, which was not statistically different from the control population's prevalence of 13%. In the MF/SS cohort, a multivariable logistic regression model showed that older patients (OR= 1.05 for each year of age, 95% confidence interval= 1.02-1.07) and those diagnosed with hypertension (OR= 3.40, 95% confidence interval= 1.71-6.75) had a higher risk of a CV event (P < 0.001). Risk factors such as gender, race, smoking, diabetes, and obesity were not significantly associated with CV events. Findings suggest that in the MF/SS population, advancing age and hypertension are risk factors for CV events, requiring clinical recognition and management. In addition, further research is needed to understand the complex interplay of how chronic inflammation in MF/SS impacts the immune development of CV disease.

Nutritional evaluation of potato milk produced by ultrasonication–A functional alternative for bovine milk

Plant-based functional beverages developed as an alternative to cow milk are gaining popularity because they are rich in bioactive and nutraceutical ingredients. Although the newly developed potato milk resembles cow milk in its physicochemical properties, its nutritional value is unknown. Accordingly, the research aimed to quantify the aggregate of macro and micronutrients in potato milk processed by ultrasonication. The macronutrients in potato milk include total calories (111.5 ± 0.09 kcal), carbohydrate content (65.3 ± 0.234 %), protein content (2.2 ± 0.0365 %), fat content (0.3 ± 0.001 %), reducing sugar (0.6 ± 0.057 %), non-reducing sugar (0.4 ± 0.023 %), total sugar (1 ± 0.087 %), and added sugar (0 %). The micronutrients assessed include calcium content (13 ± 0.023 mg/100 g), magnesium content (24.7 ± 0.089 mg/100 g), zinc content (0.26 ± 0.345 mg/100 g), sodium content (0.58 ± 0.067 mg/100 g), vitamin C content (28 ± 0.099 mg/100 g), iron content (0.82 ± 1.034 mg/100 ml), phosphorous content (84 ± 0.678 mg/100 ml), potassium content (835 ± 0.067 mg/100 g), manganese content (0.074 ± 0.423 mg/100 ml), cholesterol content (0 ± 0.586 %), and amino acid content (36 ± 0.003 mg/100 ml). As a result, the developed potato milk has adequate macro and micronutrients to maintain stable health, making it a promising alternative to dairy products with packed nutrients.

Manifestaciones dermatológicas en una lactante con síndrome de kwashiorkor: Claves para el diagnóstico y tratamiento oportuno

Kwashiorkor syndrome is characterized by protein malnutrition and edema, risk factors are recent weaning, infections, and diets based on corn and rice. This malnutrition can lead to skin manifestations such as thin, dry skin, hyperpigmentation, confluent areas of scaling, dry, hypopigmented, and detachable hair, as well as erosive dermatitis, predominantly in skin folds. The diagnosis is based on a nutritional evaluation exam, physical examination and laboratory finding, the treatment is based on early nutritional rehabilitation. Clinical case: 8-month-old female infant who attended the Instituto Nacional de Pediatría, presenting a scaling dermatosis of 1 months of evolution that was treated with topical ketoconazole. The mother reported exclusive feeding with corn gruel due to the diagnosis of “lactose allergy” and commented not enough resources to buy hydrolyzed formula. The patient presented a disseminated dermatosis to all- body segments, characterized by well-defined, irregularly shaped, hyperpigmented plaques with scaling in thick sheets in the perioral region and extremities, as well as areas of eroded skin and paleness and edema of extremities. Laboratory tests were taken, where anemia (Hb 11.2 g/dl) and hypoalbuminemia (3.3 g/dl) were documented, the diagnosis of Kwashiorkor syndrome was integrated. The clinical and laboratory findings were reported to the Gastroenterology and Nutrition service, who performed a nutritional assessment, and began nutritional treatment, emollients and general skin care were documented; twenty days later, the dermatosis and edema had subsided. Keywords: Malnutrition; dermatoses; edema; feeding; desquamation.

X- ray experimental set-up for in-vitro nail test

In this investigation, the elements Ca and S were evaluated in a single nail clipping using compact and portable X-ray spectrometer model X-123 SDD with Ag target. Experimental conditions for current, voltage and excitation time were investigated. These analyses can be useful for a variety of applications, including nutritional and medical diagnosis, such as, the evaluation of bone dysfunctions by measurement of Ca (bone decalcification) and S for nutrition evaluations (collagen production). This analysis offers some benefits comparatively to blood and serum analyses, such as, non-invasive collection, fast analyses (minutes) and low cost. In addition, nail clippings are simple to obtain, easy to store, and easy to transport. This pilot study show a positive expectation for clinical application using in-vitro nail test.