Nutrition Therapy Research Articles

Association Between Disease Severity and Frailty in Patients with Aortic Stenosis.

Frailty is highly prevalent among patients with aortic stenosis (AS). Nonetheless, the impact of AS severity on frailty remains unclear. This study aimed to clarify the association between AS severity and frailty in this population.This retrospective study included consecutive patients with AS who were hospitalized as candidates for transcatheter aortic valve implantation (TAVI). The prevalence of frailty, N-terminal pro B-type natriuretic peptide (NT-proBNP) level, gait speed, and geriatric nutritional risk index (GNRI) were compared between patients with severe and those with very severe AS. We employed multiple logistic regression analysis to examine the association between AS severity and frailty.A total of 137 patients were included. The prevalence of frailty was not significantly different between the severe and very severe AS groups (31% versus 30%). Similarly, no significant differences between the groups were observed for gait speed and GNRI, whereas the NT-proBNP level was significantly higher in the very severe group than in the severe AS group (P < 0.01). In the multiple logistic regression analysis, AS severity was not associated with frailty; however, gait speed and GNRI showed significant association with frailty independently of age, sex, and heart failure (very severe AS: odds ratio [OR] 1.051, 95% confidence interval [CI] 0.439-2.517; low gait speed: OR 5.109, 95% CI 1.556-16.775; malnutrition: OR 2.841, 95% CI 1.145-7.049).These findings suggest that low-intensity exercise training and nutritional therapy may be necessary in addition to AS treatment for the management of frailty in this population.

Nurses Knowledge Related to Enteral and Parenteral Nutritional Therapy for Unconscious Patients

Background: Enteral nutrition is the preferred method of providing essential nutrients to unconscious patients with a functioning gastrointestinal tract. Nurses play a pivotal role in ensuring safe and effective delivery of enteral nutrition therapy support, encompassing a range of responsibilities before, during, and after feeding. Objectives: 1. Assess Nurses’ knowledge regarding unconscious patients’ nutrition. 2. Identify the demographical characteristics of studied population. 3. Find out the relations between knowledge of nurses and their demographical and employment characteristics. Methodology: A descriptive –cross sectional study design is the choice to study a specific phenomenon of interest regarding assessing nurses knowledge regarding enteral and parenteral nutritional therapy from period between (November 2022- July 2024). Non-probability convenient sample of (125) nurses who work in the intensive care units were selected. This study conducted in the intensive care units which located at three teaching hospitals in Al-Hilla city- Iraq. Results: The data reveals that the majority, at 55.2%, fall within the 20-30 year age range. Interestingly, the sex distribution is nearly equal with 52% males and 48% females. The result recorded high percentage fair level of nurses knowledge according to sum score. Conclusion: Nurses demonstrate significant gaps in knowledge across various aspects of ENT, including indications, complications, and nutritional content.

Nurses Practices Related to Enteral and Parenteral Nutritional Therapy for Unconscious Patients

Background: Enteral nutrition reduces the mortality rate and prevents the development of pressure sores. Specific complications with parenteral nutrition, particularly in unconscious patients, include line sepsis and fluid and electrolyte imbalance. This is important because parenteral nutrition reduces the duration of unconscious patients' hospital stay. Objectives: 1. Assess Nurses’ practice regarding unconscious patients’ nutrition. 2. Identify the demographical characteristics of studied population. 3. Find out the relations between practices of nurses and their demographical and employment characteristics. Methodology: A descriptive – observational study design is the choice to study a specific phenomenon of interest regarding assessing nurses practices regarding enteral and parenteral nutritional therapy from period between (November 2022- July 2024). Non-probability convenient sample of (125) nurses who work in the intensive care units were selected. This study conducted in the intensive care units which located at three teaching hospitals in Al-Hilla city- Iraq. Results: The data reveals that the majority, 55.2%, fall within the 20-30 year age range. Interestingly, the sex distribution is nearly equal with 52% males and 48% females. The result recorded the major of study sample were poor level of practice regarding enteral and parenteral nutritional therapy for unconscious patients. Conclusion: There is a substantial need for improvement in nursing practices related to ENT, such as nutritional assessment, equipment preparation, and adherence to protocols.

Clinical nutrition approach to colon cancer

Colon cancer is a type of cancer that affects the large intestine or rectum, with risk increasing with age. It typically shows no symptoms in its early stages and is often diagnosed in advanced stages, where treatment options are limited. In 2020, there were approximately 1.9 million new colorectal cancer cases and over 930,000 deaths worldwide. Colorectal cancer is the third most common cancer globally and the second leading cause of cancer-related deaths. Colon polyps are precancerous lesions identified through colonoscopy. The size, surface structure, and number of polyps are associated with the risk of colon cancer. Colonoscopy is an effective method for detecting and removing adenomatous polyps, thus preventing death from colorectal cancer. The treatment of colon cancer, including surgery and other methods, can lead to various metabolic and digestive complications. Nutrition plays a crucial role in cancer treatment and prevention. A balanced diet can improve treatment outcomes and quality of life. Nutritional support is essential alongside surgical or pharmacological treatments. Oral Nutritional Supplements (ONS) are recommended for cancer patients with inadequate oral intake. Studies have shown that nutritional supplementation before and after surgery can improve recovery and walking capacity in colorectal cancer patients. Enteral Nutrition (EN) is used to provide essential nutrients in individuals with insufficient oral intake. It is recommended postoperatively as soon as the gastrointestinal tract is active, reducing complications and improving recovery. Parenteral Nutrition (PN) is crucial when oral or enteral nutrition is not feasible. PN, particularly Total Parenteral Nutrition (TPN), is beneficial in severely malnourished patients and those undergoing major surgery, reducing infection risk and improving overall nutritional status. In conclusion, the effective use of enteral and parenteral nutrition strategies in colon cancer treatment improves patients' quality of life and increases treatment success rates. Integrating nutritional therapy into cancer treatment protocols is of great importance.

Nutritional and Organoleptic Value in the Formula Enteral of Growol and Germinated Mung Bean Flour as an Alternative Enteral Type 2 Diabetes Mellitus

Background: Type 2 Diabetes Mellitus (T2DM) is a metabolic disease characterized by increased blood glucose. Nutritional support rich in dietary fiber and high protein can stimulate insulin secretion, thereby inhibiting increased blood glucose. Enteral of Growol-Germinated Mung Bean Flour (ENGROCAJO) is a formula developed from growol flour and germinated mung bean flour. It contains high dietary fiber with protein and is an alternative nutritional therapy for people with T2DM. Hospital Diabetes Mellitus (DM) enteral formula administered to patients is limited to dietary fiber. Objectives: This study aimed to analyze the nutritional value and organoleptic value of the ENGROCAJO formula and compare it with the hospital DM enteral formula. Methods: This was an observational laboratory study developed an enteral formula from growol and germinated mung bean flour. It analyzed the nutritional value using proximate and dietary fiber analysis. The organoleptic assessment utilized a hedonic test with 20 participants. The nutritional and organoleptic contents were compared with hospital DM enteral formula. The difference test between formulas was tested using Kruskal-Wallis with a significant value of p&lt;0.05. Results: The nutritional content in 100 g of ENGROCAJO formula and hospital DM enteral formula includes energy of 386.86 and 329.49 kcal, protein of 41.38% and 20.43%, fat of 2.78% and 8.88%, carbohydrate of 49.08% and 38.55% with dietary fiber of 22.43% and 3.62%. Organoleptic assessment of aroma, color, flavor, and thickness showed that the ENGROCAJO formula had higher quality than the hospital DM enteral formula. However, the flavor aspect showed significant difference (p=0.038). Conclusions: ENGROCAJO formula contains higher protein and dietary fiber compared to the hospital DM enteral formula. There was a significant difference in the organoleptic taste between the ENGROCAJO formula and the hospital DM enteral formula.

Compensation for metabolic dietitians practicing in the United States: 2023 genetic metabolic dietitians international professional status survey

BackgroundGenetic Metabolic Dietitians International (GMDI) conducted a professional status survey of metabolic dietitians working in the United States to describe job satisfaction and establish salary and compensation benchmarks specific to metabolic dietitians. MethodsThe survey was anonymously administered in a web-based format via REDCap between October and November 2023. Registered dietitians working with inborn errors of metabolism (IEM) were eligible to participate. ResultsA total of 178 surveys were received and 147 were included in the final analysis. Most respondents were female (96 %), worked in a clinical setting (83 %), and held a graduate degree (75 %), while 30 % had one or more board certifications and 8 % were faculty. Respondents specialized in genetic metabolic nutrition for a median of 6 years (IQR 2–15). Overall satisfaction with one's professional focus in IEM was high among respondents (87 %), though 40 % reported dissatisfaction with earnings potential in their current position.The median annual, full-time salary for US-based metabolic dietitians in all work settings was $80,400 (IQR $67,100-96,000). After excluding dietitians working in the pharmaceutical and/or nutrition industry (n = 14), the median annual salary decreased to $76,200 (IQR $66,700-91,000). Increased years' experience, responsibility (e.g., supervisor), expertise (i.e., board certification), and categorization as a Level II dietitian or higher were associated with higher annual salary. ConclusionThe results of the 2023 GMDI Professional Status Survey provide insight into the current compensation and benefits of metabolic dietitians practicing in the US. These data can be used to support individual efforts to secure equitable compensation for the metabolic dietitian's critical role in the medical nutrition therapy for individuals with IEM.

Nutritional risk, nutrition impact symptoms, and dietary intake after four or more days of admission: A cross-sectional study on hospitalised patients

BackgroundRegular audits on nutrition screening, therapy, and dietary intake monitoring are essential for ensuring optimal nutrition practice. This study aimed to investigate the prevalence of nutritional risk, nutritional coverage, and nutrition impact symptoms (NIS) in hospitalized patients. MethodsA cross-sectional study was conducted, including adult patients admitted for ≥5 days on November 1, 2023. Data were collected from medical records to estimate the prevalence of nutritional risk using the NRS-2002 score. Additionally, data on dietary intake and NIS were collected through interviews with patients identified as being at nutritional risk. ResultsA total of 104 patients (48% females) were included in the study, with 51% identified as being at nutritional risk. Patients at nutritional risk and those not at risk differed significantly in terms of length of admission (median 9 (IQR: 7-17) vs. 7 days (6-11), p=0.015) and BMI (median 22.3 (IQR: 20.3-27.7) vs. 25.9 (22.9-29.7), p=0.015). Patients at nutritional risk had a median energy coverage of 60% (IQR: 38-87) and a median protein coverage of 45% (IQR: 36-82). However, only 42% of them achieved an energy intake of ≥75% of the estimated requirement, while 28% met the same level for protein intake. The most prevalent NIS affecting dietary intake was 'diarrhea, constipation, or discomfort from the stomach', reported by 50% of patients. ConclusionThis study highlights the significant prevalence of nutritional risk among hospitalised patients, with one in every two patients identified as being at risk. Despite efforts, nutritional needs were not adequately met, particularly regarding protein intake. Regular audits and interdisciplinary collaboration are necessary for improving nutritional care and outcomes in hospital settings.

Individualized nutritional therapy in a patient with chronic critical illness

Individualized nutritional therapy in a patient with chronic critical illness

Clinical characteristics, treatment strategy, and clinical outcomes in type 2 intestinal failure

Objective: To evaluate the characteristics, clinical management and clinical outcomes of type 2 intestinal failure (IF). Methods: A descriptive case-control study was carried out. The inclusion criteria were as follows: (1) the diagnosis of IF was performed according to the European Society for Parenteral and Enteral Nutrition (ESPEN) consensus statement. (2) using a requirement for parenteral nutrition (PN) of 28 days or more as surrogate marker. (3) a multidisciplinary team (MDT) included surgeons, nutritionist, pharmacist, stoma therapists, and critical care physicians. (4) complete laboratory data. Patients with type 1 and type 3 IF and those who do not cooperate with follow-up. All the data of 67 type II IF were collected from the database in Sir Run Run Shaw Hospital from Jan 2016 to Dec 2023. The pathophysiology, clinical management, and outcomes of type II IF were analyzed. Results: A total of 67 type II IF were included. The median age was 54 (15-83) with 43 males and 24 females. The body mass index was (17.5±3.8) kg/m2, the incidence of malnutrition was 67.2% (45/67), the incidence of sarcopenia was 74.6% (50/67), the median number of previous surgeries was 2.0 (1-13), and the median duration time of PN was 2.1 (1-12) months. The underlying disease of type 2 IF included 36 Crohn`s disease, 2 ulcerative colitis, 3 radiation enteritis, 2 intestinal Behcet's disease, 4 mesenteric infarction, 1 aggressive fibromatosis, 5 abdominal cocoon syndrome, 5 gastrointestinal perforation, 1 hernia, 4 intestinal dysmotility, and 4 other reasons (gastrointestinal tumor, trauma, and non-Hodgkin's lymphoma). According to the pathophysiology of IF, there were 33 intestinal fistula, 12 intestinal dysmotility, 6 mechanical obstruction, 13 short bowel syndrome, and 3 extensive small bowel mucosal disease. After treatment with MDT, 67 patients with type 2 IF received nutritional support therapy for intestinal rehabilitation treatment, of which 36 patients recovered with oral diet or enteral nutrition, 31 patients underwent reconstructive surgery after intestinal rehabilitation treatment failure. The median duration time of reconstructive surgery was 2.7 (1-9) months. 24 patients recovered intestinal autonomy after surgery, with 7 deaths, including 6 deaths due to abdominal infections and 1 case of intestinal dysmotility with abiotrophy and liver failure. Conclusion: Standardized multidisciplinary treatment plays an important role in type II intestinal failure, and it promotes patients with intestinal failure regain enteral autonomy.

Tongue pressure, respiratory muscle and limb strength and functional exercise capacity in oesophageal cancer

ObjectivesPreoperative management of oesophageal cancer requires effective prehabilitation. This study investigates the relationship between tongue pressure, respiratory muscle, handgrip and lower limb muscle strengths, and functional exercise capacity in patients...

ASPEN international survey on ethical competencies dealing with decision-making in the use of artificially administered nutrition and hydration and competency application in clinical practice.

Ethical competencies dealing with decision-making for clinicians involved in artificially administered nutrition and hydration (AANH) have not been defined in the literature. Although clinical assessments identify nutrition needs and appropriate routes of nutrition administration, an assessment of the ethical, cultural, and spiritual implications of the medical nutrition therapy may be overlooked. Eleven competency statements were developed by members of two international sections of the American Society for Parenteral and Enteral Nutrition. This descriptive cross-sectional survey study was conducted to measure the importance of the competency statements to the membership of two sections using a five-point Likert scale of 1-5 (1-low to 5-high). A total of 113 responses (12.5% response rate) were obtained predominantly from physicians and dietitians from 25 countries. There was a wide range of world regions of the 49% respondents outside of the United States. Means and SDs were calculated for agreement with the 11 competency statements with overall means ranging from 4.32 to 4.67. Most of the participants cared for adult/older adult patients (63.7%) exclusively, and 12.4% cared for pediatric/neonate patients exclusively; the remainder (23.9%) cared for both populations. Respondents reported they were either experienced, competent, or expert (88.6%) in dealing with ethical issues related to AANH. This international interdisciplinary group agreed that the integration of ethical, cultural, and spiritual competencies into clinical decision-making regarding artificially AANH is important.

An Integrative Approach for Endometriosis-Related Pain.

Pain is a common, severe symptom related to endometriosis. Despite this prominent feature, there is limited literature regarding its description and use of integrative treatment methods. We aimed to describe endometriosis-related pain characteristics, severity, and association with an integrative approach encompassing pharmacological and non-pharmacological methods. A cross-sectional descriptive correlational study was conducted using convenience sampling of adult women with endometriosis-related pain. Three questionnaires were utilized: a demographic and general health questionnaire, a visual analog pain scale (VAS), and the short-form McGill pain questionnaire (SF-MPQ). Participants included 93 women with a mean general pain level of 6.2/10 (SD = 2.7) on the VAS. The total mean pain score on the SF-MPQ was 26.25/45 (SD = 10.1). Sixty-four women (68.8%) reported experiencing pain at the time of completion of the questionnaire (mean: 1.6/4, SD = 1.3). All participants utilized analgesia; those who used opioids reported a higher overall mean pain score of 2.3 (SD = 1.3) than patients who did not use opioids reported a mean of 1.4 (SD = 1.2; z = 9.59; P < .001). Present pain intensity was significantly higher for women using opioids than those not using opioids. In all, 77 women (82.8%) used integrative methods to alleviate the pain symptoms. Women who utilized nutritional therapy as part of the non-pharmacological method experienced lower mean (SD) overall pain (4.4 [2.5]) compared with patients who did not utilize nutritional therapy (6.75 [2.5]; P < .01). More studies are needed to find evidence-based treatment options for women for integrative pain relief for endometriosis-related pain.

Strategies for minimizing muscle loss during use of incretin-mimetic drugs for treatment of obesity.

The rapid and widespread clinical adoption of highly effective incretin-mimetic drugs (IMDs), particularly semaglutide and tirzepatide, for the treatment of obesity has outpaced the updating of clinical practice guidelines. Consequently, many patients may be at risk for adverse effects and uncertain long-term outcomes related to the use of these drugs. Of emerging concern is the loss of skeletal muscle mass and function that can accompany rapid substantial weight reduction; such losses can lead to reduced functional and metabolic health, weight cycling, compromised quality of life, and other adverse outcomes. Available evidence suggests that clinical trial participants receiving IMDs for the treatment of obesity lost 10% or more of their muscle mass during the 68- to 72-week interventions, approximately equivalent to 20 years of age-related muscle loss. The ability to maintain muscle mass during caloric restriction-induced weight reduction is influenced by two key factors: nutrition and physical exercise. Nutrition therapy should ensure adequate intake and absorption of high-quality protein and micronutrients, which may require the use of oral nutritional supplements. Additionally, concurrent physical activity, especially resistance training, has been shown to effectively minimize loss of muscle mass and function during weight reduction therapy. All patients receiving IMDs for obesity should participate in comprehensive treatment programs emphasizing adequate protein and micronutrient intakes, as well as resistance training, to preserve muscle mass and function, maximize the benefit of IMD therapy, and minimize potential risks.

Effect of body mass index on post-treatment oral function in patients with oral cancer: a cross-sectional study

This single-center cross-sectional study used sequential sampling to examine the influence of body mass index (BMI) on oral function after oral cancer treatment. Patients who completed primary oral cancer treatment between September 2019 and March 2023 (102 patients, 74 male [72.5%] and 28 female [27.5%]; mean age, 69.6 years) were analyzed. Patient background data were collected from electronic medical records. Post-treatment oral function measurements were conducted on all patients using six assessment tools. Statistical analysis was conducted using Pearson’s correlation coefficient, one-way analysis of variance, the Jonckheere–Terpstra test, and multiple linear regression. Pre-treatment BMI showed a statistically significant relationship with postoperative oral function, particularly tongue pressure (P = 0.01). While the mean values of the groups showed no significant differences, the Jonckheere–Terpstra test revealed a statistically significant trend toward a stepwise increase in tongue pressure for each BMI group (P = 0.03). Multiple linear regression analysis revealed a statistically significant correlation between tongue pressure and pre-treatment BMI (P < 0.05). Pre-treatment BMI was significantly associated with tongue pressure. Since BMI is a variable factor that can be controlled by nutritional therapy even before treatment, nutritional intervention, weight control, and treatment strategies including reconstructive interventions to maintain tongue pressure may be important in oral cancer treatment.

Positive impact of nutrition in the prevention of peripheral vascular disease and severe acute respiratory syndrome coronavirus 2: review.

Recent research has shown that there is a link between the trend of cardiovascular disease (CVD), chronic symptoms of SARS-CoV-2 (COVID-19), and medical nutrition therapy. Making positive changes to an individual's lifestyle can help to reduce the symptoms that follow exposure to CVD and COVID-19. Sustainable nutrition and lifestyle changes can positively impact an individual's health. Studies have considered the risk factors associated with the disease, medical history, the link between nutrition and peripheral vascular disease (PVD), symptom management, and the interrelationship between nutrition, COVID-19, and PVD. One study has demonstrated that Western Dietary intake can boost the innate immune system while suppressing humoral response, causing chronic inflammation and poor host defense against viruses. However, further investigation is needed to confirm. Patients with PVD and COVID-19 have experienced a reduction in side effects when prescribed a regimen of medical nutrition therapy, heart-healthy diets, and adequate physical activity before and after symptoms of both diseases appear. This approach has proven to be a protective factor during the combination of both illnesses. Our findings indicate that balanced diet and lifestyle are essential in supporting an optimal immune system that can reduce the risk of virus load in individuals at risk of infection and symptoms from COVID-19 and PVD.

The oral intake of specific Bioactive Collagen Peptides (BCP) improves gait and quality of life in canine osteoarthritis patients—A translational large animal model for a nutritional therapy option

Objective Osteoarthritis (OA) is the most common joint disorder in humans and dogs. Due to its chronic progressive nature, the predominant clinical signs after a certain point are pain and immobility. The similar pathogenesis allows conclusions to be drawn from canine to human OA. Current treatments are limited and often attempt to treat OA symptoms rather than improve joint structure and function. Collagen hydrolysates as oral supplements are a promising therapeutic option to achieve this advanced therapeutic aim in both species. The effects of oral supplementation were therefore investigated in canine OA patients. Method In a systematic, placebo-controlled, double-blind interventional study in 31 dogs with naturally occurring OA, the efficacy of oral supplementation of specific bioactive collagen peptides (BCP) was tested in comparison to the approved combination of the active substances omega-3 fatty acids and vitamin E. The dogs were examined on a horizontal treadmill with 4 integrated piezoelectric force plates at the beginning and end of a twelve-week test period. At both points, the owners completed a specific questionnaire containing the validated Canine Brief Pain Inventory (CBPI) and the dogs were fitted with accelerometers to record total daily activity data. Results Only the oral supplementation of BCP resulted in a significant improvement of several kinetic parameters measured using a force-plate fitted treadmill, and the quality of life assessed by CBPI, while accelerometry was unaffected by the intervention. Conclusion The results of this three-month BCP supplementation study using objective measurement parameters in dogs with naturally occurring OA demonstrate an efficacy, suggesting the therapeutic use of BCP in canine OA patients and demonstrating the relevance of this collagen hydrolysate formulation for the treatment of OA in human patients as well.

Date palm: a potential nutraceutical and phytomedicine in most frequent aging associated diseases

AbstractSenescence, often known as ageing, is a condition of decline that shows itself as a decrease in fertility and survival at older ages. Ageing theory suggests that ageing evolves as a function of life history optimization or because of mutation pressure, depending on the degree of externally imposed mortality and shocks to fertility. An important key factor to many aging-related disorders (ARDs), such as hypertension, myocardial infarction, atherosclerosis, osteoporosis, cancer, and neurodegenerative diseases like Alzheimer’s and Parkinson’s disease, is ageing, a process influenced by countless biological and genetic pathways. While there have been significant advancements in therapeutics for age-related disorders, nutritional therapy, encasing various products from natural sources is recommended for durable and fruitful treatment. Numerous health advantages of the date palm, Phoenix dactylifera, have been well-documented. These include antioxidant, anti-inflammatory, cardioprotective, and neuroprotective activity. Phytochemical analysis of date palm demonstrates a lot of beneficial nutraceuticals that can ameliorate ARDs like polyphenols, phytosterols, carotenoids, flavonoids, terpenoids, fatty acids, carbohydrates, vitamins, and amino acids etc. The major signaling and molecular pathways by which these phytoconstituents exert their anti-ageing effects include terminating inflammation by blocking the release in of IL-6, TNF-α and clearance of Aβ plaques for neurodegenerative diseases; blocking ACE-II and HMG-CoA for cardio-protection; regulating RANK, p38MAPK-Runx2 pathways, and insulin-growth factor-1 (IGF-1) for osteoporosis. However, research on the benefits of date palm is still lacking. The purpose of this review is to shed light on the various biological activities of date palm in ARDs and to explore its remedial mechanisms.

A nutrition-focused review of the interventions in US-living Latino communities with type II diabetes.

Type 2 diabetes (T2D) is a chronic, debilitating disease that disproportionally affects the Hispanic/Latino community residing in the United States. Optimal nutrition therapy is fundamental to the proper management of T2D and must be culturally adapted to facilitate permanent behavior change in this population. This review selected and assessed the nutrition components of interventions aimed to improve T2D outcomes in US-based Latinos/Hispanics, published from 2002 to 2023. An overview of the participant characteristics, nutrition intervention, and dietary assessment and outcomes is included. Nutrition interventions in this community benefit from the inclusion of bicultural registered dietitian nutritionist (RDNs) to assure the counseling team promotes culturally tailored nutrition recommendations based on current dietary guidelines. Nutrition assessment and outcomes should be captured with the use of validated dietary assessment tools and dietary quality indices appropriate to their target population. Standardizing these practices will facilitate intervention comparability and replicability and ultimately better target the needs of this community.

Family strategies for managing childhood cancer: Using traditional and complementary medicine in Southern Egypt.

The use of traditional and complementary medicine (T&CM) is common in children with cancer globally. We aimed to assess the prevalence, types, reasons, perceived effectiveness, and disclosure rate of T&CM use among children with cancer in Southern Egypt. We also investigated whether T&CM use contributed to delays in initial presentation and treatment. A cross-sectional design was utilized. Data were collected via an interviewer-administered questionnaire. Eligible children and their caregivers at the South Egypt Cancer Institute were invited to participate. Eighty-six children completed the study (response rate=86%). T&CM use was reported by 52 (60.5%) patients, with six (11.5%) experienced delayed presentation. The reasons for T&CM use were complementary for 37 (71%) and alternative for 15 (29%) of the participants. The types of T&CM used included herbal (63%), nutritional (33%), witchcraft (29%), and religious (19%) therapies. Approximately 48% of users employed multiple T&CM types. Family members recommended T&CM for 60% of the users. Most patients (65%) perceived T&CM as effective, with 71% initiating its use during the early phases of treatment. Almost all participants (98%) reported that healthcare providers did not inquire about T&CM use. T&CM usage was more prevalent among wealthier families (p=.023). There was no significant relationship between T&CM use and patient gender, diagnosis, residence, or paternal educational level. The significant utilization of T&CM among children with cancer highlights the need for healthcare providers to engage in open and early discussions with families regarding T&CM use.

Profiles and interactions of gut microbiome and intestinal microRNAs in pediatric Crohn's disease.

Since previous studies have focused on the change of the fecal gut microbiome and intestinal tissue miRNA in pediatric Crohn's disease (CD), the relationship between them in different stages is still not clear. This is the first study to explore the gut microbiota and miRNA and their correlations with the Pediatric Crohn's Disease Activity Index (PCDAI). Crohn's Disease Endoscopic Index of Severity (CDEIS), and calprotectin, by applying two omics approach in three different groups (active CD, CD in remission with exclusive enteral nutrition or infliximab induction therapy, and the healthy controls). Both gut microbiome structure and the miRNA profiles were significantly changed in the different stage of CD. Seven key gut microbiome at species and eight key miRNAs were found, and their close interactions were further fully investigated by miRNA target prediction.