Medical Foods: Science, Regulation, and Practical Aspects. Summary of a Workshop

ABSTRACT On August 13–14, 2019, the Healthcare Nutrition Council and the ASN held the Medical Foods Workshop: Science, Regulation, and Practical Aspects. Medical food products help patients manage their disease and improve their quality of life. Yet many hurdles exist to getting patients new products. In this workshop, participants addressed some of these hurdles, with specific emphasis on topics like the statutory term distinctive nutritional requirements, the regulatory term modification of the diet alone, the role of clinical guidelines, the requirement that medical foods be used under medical supervision, and differentiation of foods for special dietary use from medical foods, as well as product innovation and future research. Real-world examples were discussed for intractable epilepsy, diabetes, end-stage renal disease, and inflammatory bowel disease.

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Use of Rifaximin in Irritable Bowel Syndrome Treatment

Journal of Education, Health and Sport ◽

10.12775/jehs.2021.11.08.025 ◽

2021 ◽

Vol 11 (8) ◽

pp. 247-254

Author(s):

Hubert Wróblewski ◽

Aleksandra Zimna

Keyword(s):

Irritable Bowel Syndrome ◽

Causal Therapy ◽

Related Quality ◽

Health Related ◽

Inflammatory Bowel ◽

Irritable Bowel ◽

Stage Renal Disease ◽

End Stage ◽

Positive Effect

Introduction and purpose of the work: Irritable Bowel Syndrome (IBS) affects up to 10% of the population. The deterioration in health-related quality of life in IBS patients has been shown to be comparable to, and perhaps even more severe than, other serious chronic organic diseases such as inflammatory bowel disease, diabetes, hypertension, and end-stage renal disease. The aim of the study is to present a new method of IBS treatment.State of knowledge: There are four main types of IBS: Constipation-predominant IBS (IBS-C), Diarrhea-predominant IBS (IBS-D), Fluctuating IBS (IBS-M), and the unclassified form of IBS (IBS-U). Disturbances in entero-brain interactions play a key role in its multifactorial etiopathogenesis. In patients with IBS, quantitative and qualitative disturbances in the composition of the intestinal microbiota can be found. So far, it has not been possible to clearly establish the cause of the disease, so there is no possibility of causal therapy and effective cure. Both non-pharmacological methods and drugs, including rifaximin α, have been used in IBS therapy.Summary: Rifaximin has a positive effect on the symptoms of IBS. In clinical trials conducted in patients with IBS, the use of rifaximin for 2 weeks was associated with a reduction in the severity of joint symptoms, bloating, abdominal pain and discomfort, and an improvement in stool consistency within 4 and 12 weeks, and did not increase the risk of side effects. In the forms: with predominant diarrhea, mixed and unclassified, in order to reduce the overall symptoms as well as reduce the severity of flatulence and / or diarrhea, a 14-day therapy with rifaximin α is recommended.

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Peran Perawat Dalam Meningkatkan Kualitas Pasien Peritonial Dialisis

Jurnal Keperawatan Indonesia ◽

10.7454/jki.v11i1.182 ◽

2007 ◽

Vol 11 (1) ◽

pp. 25-29

Author(s):

Krisna Yetti

Keyword(s):

Peritoneal Dialysis ◽

Care Provider ◽

End Stage Renal Disease ◽

The Other ◽

Stage Renal Disease ◽

End Stage ◽

And Function ◽

Role And Function

AbstrakContinuous Ambulatory Peritoneal Dialysis (CAPD) merupakan salah satu terapi pengganti pada Penyakit Ginjal Tahap Akhir (PGTA). Empat area yang menjadi tanggung jawab perawat CAPD adalah predialisis, rawat inap, sebelum dan selama pelatihan CAPD, serta pada saat pasien di rumah. Merujuk pada empat peran perawat, yaitu sebagai praktisi, pengelola, peneliti, dan pendidik, maka peran perawat CAPD mempunya peran dan fungsi yang berbeda pula pada masing-masing area ini. Tujuan utama peran dan fungsi perawat di setiap area ini adalah agar layanan keperawatan yang diterima oleh pasien menjadi prima. Pada artikel ini dibahas peran perawat sebagai praktisi dan pengelola pelayanan keperawatan. Sedangkan dua peran lagi yaitu pendidik dan peneliti tidak dibahas. AbstractContinuous Ambulatory Peritoneal Dialysis (CAPD) is one of replacement therapy of End Stage Renal Disease (ESRD). CAPD nurse takes the responsibility in four areas. Those are pre-dialysis stage, during hospitalization, before and during peritoneal dialysis training, and patient at home. Refer to the roles of the nurses, as a care provider, manager, educator and researcher, CAPD nurse has a comprehensible role and function. This comprehensible role and function is also applied in this each area in order to get the better quality of life of the CAPD patients. In this article the role of care provider and manager are discussed. However, the other two, educator and researcher roles are not discussed.

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Potential role of extracellular vesicles in the pathophysiology of glomerular diseases

Clinical Science ◽

10.1042/cs20200766 ◽

2020 ◽

Vol 134 (20) ◽

pp. 2741-2754

Author(s):

Xia-Qing Li ◽

Lilach O. Lerman ◽

Yu Meng

Keyword(s):

Extracellular Vesicles ◽

Biological Fluids ◽

Management Strategies ◽

Renal Diseases ◽

Future Research ◽

Target Cells ◽

Glomerular Diseases ◽

Stage Renal Disease ◽

End Stage

Abstract Extracellular vesicles (EVs) are membrane-bound vesicles released by most cells and are found in diverse biological fluids. The release of EVs provides a new mechanism for intercellular communication, allowing cells to transfer their functional cargoes to target cells. Glomerular diseases account for a large proportion of end-stage renal disease (ESRD) worldwide. In recent years, an increasing number of research groups have focused their effort on identifying the functional role of EVs in renal diseases. However, the involvement of EVs in the pathophysiology of glomerular diseases has not been comprehensively described and discussed. In this review, we first briefly introduce the characteristics of EVs. Then, we describe the involvement of EVs in the mechanisms underlying glomerular diseases, including immunological and fibrotic processes. We also discuss what functions EVs derived from different kidney cells have in glomerular diseases and how EVs exert their effects through different signaling pathways. Furthermore, we summarize recent advances in the knowledge of EV involvement in the pathogenesis of various glomerular diseases. Finally, we propose future research directions for identifying better management strategies for glomerular diseases.

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Role of Myeloperoxidase in Patients with Chronic Kidney Disease

Oxidative Medicine and Cellular Longevity ◽

10.1155/2016/1069743 ◽

2016 ◽

Vol 2016 ◽

pp. 1-10 ◽

Cited By ~ 30

Author(s):

Bojana Kisic ◽

Dijana Miric ◽

Ilija Dragojevic ◽

Julijana Rasic ◽

Ljiljana Popovic

Keyword(s):

Oxidative Stress ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Public Health Problem ◽

Cardiovascular Complications ◽

The Body ◽

Stage Renal Disease ◽

End Stage

Chronic kidney disease (CKD) is a worldwide public health problem. Patients with CKD have a number of disorders in the organism, and the presence of oxidative stress and systemic inflammation in these patients is the subject of numerous studies. Chronic inflammation joined with oxidative stress contributes to the development of numerous complications: accelerated atherosclerosis process and cardiovascular disease, emergence of Type 2 diabetes mellitus, development of malnutrition, anaemia, hyperparathyroidism, and so forth, affecting the prognosis and quality of life of patients with CKD. In this review we presented the potential role of the myeloperoxidase enzyme in the production of reactive/chlorinating intermediates and their role in oxidative damage to biomolecules in the body of patients with chronic kidney disease and end-stage renal disease. In addition, we discussed the role of modified lipoprotein particles under the influence of prooxidant MPO intermediates in the development of endothelial changes and cardiovascular complications in renal failure.

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Psychological Aspects of Renal Transplantation

The International Journal of Psychiatry in Medicine ◽

10.2190/v83t-jneh-m285-1lvu ◽

1983 ◽

Vol 12 (3) ◽

pp. 229-236 ◽

Cited By ~ 7

Author(s):

Marcia Chambers

Keyword(s):

Renal Transplantation ◽

End Stage Renal Disease ◽

Fear Of Death ◽

Psychological Reactions ◽

Stage Renal Disease ◽

End Stage ◽

Patients Experience ◽

Anxiety Depression

Renal transplantation offers the patient with end stage renal disease an alternative treatment to dialysis. A successful graft can lead to a greatly improved quality of life. Physicians, staff and patients often do not anticipate the adverse post-operative psychological reactions. At some stage, practically all patients experience episodes of anxiety, depression and anger secondary to complications, painful treatments, drug therapy, fear of death, etc. This article explores the psychological stages a renal transplantee goes through in the first few months postoperatively. Additionally, the role of the mental health consultant is examined.

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Dietary Modifications in Fissure-in-ano: A Qualitative Study Based on Persian Medicine

Current Nutrition & Food Science ◽

10.2174/1573401314666180924123007 ◽

2020 ◽

Vol 16 (6) ◽

pp. 860-865

Author(s):

Sedigheh Tavakoli-Dastjerdi ◽

Mandana Tavakkoli-Kakhki ◽

Ali R. Derakhshan ◽

Azam Teimouri ◽

Malihe Motavasselian

Keyword(s):

Modern Medicine ◽

Integrative Approach ◽

Future Research ◽

Common Disease ◽

Fissure In Ano ◽

High Fiber ◽

Baked Goods ◽

Persian Medicine

Background: Anal fissure (AF) is a common disease associated with severe pain and reduced quality of life. Factors related to lifestyle, including diet and bowel habits, play a pivotal role in its pathogenesis. Most of the chronic fissures are not responsive to drugs and more likely to recur. Given the significance of diet in Persian medicine (PM), investigation on physiopathology and appropriate foods can be useful for decreases in AF symptoms and consequences. Objective: This study was intended to evaluate the role of diet in the formation and progression of AF from the perspective of PM. Methods: In this study, the most important resources of PM dating back to thousands of years were reviewed. All these textbooks contained a section on AF, its causes, and treatment. Further analysis was performed on these resources in comparison with databank and resources of modern medicine to develop a food-based strategy for AF management. Results: From the view of PM, the warmth and dryness of anus temperament accounted for AF. Both Persian and modern medicine identified constipation as another cause for AF. Therefore, avoidance from some foods and commercial baked goods was recommended. Both Persian and modern medicine forbad the following foods: potato, cabbage, cauliflower, pasta, beef, fish, and so forth. High fiber and oligo-antigen diets with some limitations have garnered more attention. Conclusion: An integrative approach is recommended employing both Persian and modern medicine for AF. There have been some evidence in this regard, however standardized clinical trials are required for future research.

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Providers’ View on the First Kidney Transplantation Center in Ethiopia: Experience From Past to Present

Health Services Research and Managerial Epidemiology ◽

10.1177/23333928211018335 ◽

2021 ◽

Vol 8 ◽

pp. 233339282110183

Author(s):

Tariku Shimels ◽

Abrham Getachew ◽

Mekdim Tadesse ◽

Alison Thompson

Keyword(s):

Kidney Transplantation ◽

Renal Transplant ◽

Health Care Providers ◽

Study Data ◽

Care Providers ◽

Transplant Center ◽

Transplantation Center ◽

Stage Renal Disease ◽

End Stage

Introduction: Transplantation is the optimal management for patients with end-stage renal disease. In Ethiopia, the first national kidney transplantation center was opened at St. Paul’s Hospital Millennium Medical College in September 2015. The aim of this study was to explore providers’ views and experiences of the past to present at this center. Methods: A qualitative study design was employed from 1st November to 15th December, 2019. To ensure that appropriate informants would provide rich study data, 8 health care providers and top management members were purposefully chosen for in-depth interviews. A maximum variation sampling method was considered to include a representative sample of informants. Interviews were digitally audio-recorded, and transcribed verbatim. Transcribed data was coded and analyzed using Qualitative Data Analysis (QDA) Minor Lite software and Microsoft-Excel. Result: The participants (5 males and 3 females) approached were from different departments of the renal transplant center, and the main hospital. Eight main themes and 18 sub-themes were generated initially from all interviews totaling to 109 index codes. Further evaluation and recoding retained 5 main themes, and 14 sub-themes. The main themes are; challenges experienced during and after launching the center, commitment, sympathy and satisfaction, outcomes of renal transplant, actions to improve the quality of service, and how the transplant center should operate. Providers claim that they discharge their responsibilities through proper commitment and compassion, paying no attention to incentive packages. They also explained that renal transplantation would have all the outcomes related to economic, humanistic and clinical facets. Conclusion and Recommendation: A multitude of challenges were faced during and after the establishment of the first renal transplant center in Ethiopia. Providers discharge their responsibility through a proper compassion for patients. Concerned stakeholders should actively collaborate to improve the quality of renal transplant services in the center.

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Ethnic Differences in the Smoking-Related Risk of Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjab047 ◽

2021 ◽

Author(s):

Daniele Piovani ◽

Claudia Pansieri ◽

Soumya R R Kotha ◽

Amanda C Piazza ◽

Celia-Louise Comberg ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Latin American ◽

Bowel Disease ◽

Meta Analysis ◽

Study Data ◽

Future Research ◽

Related Risk ◽

Increased Risk ◽

Inflammatory Bowel

Abstract Background and aims The association between smoking and inflammatory bowel disease (IBD) relies on old meta-analyses including exclusively non-Jewish White populations. Uncertainty persists regarding the role of smoking in other ethnicities. Methods We systematically searched Medline/PubMed, Embase and Scopus for studies examining tobacco smoking and the risk of developing IBD, i.e., Crohn’s disease (CD) or ulcerative colitis (UC). Two authors independently extracted study data and assessed each study’s risk-of-bias. We examined heterogeneity and small-study effect, and calculated summary estimates using random-effects models. Stratified analyses and meta-regression were employed to study the association between study-level characteristics and effect estimates. The strength of epidemiological evidence was assessed through prespecified criteria. Results We synthesized 57 studies examining the smoking-related risk of developing CD and UC. Non-Jewish White smokers were at increased risk of CD (29 studies; RR: 1.95, 95% CI: 1.69‒2.24; moderate evidence). No association was observed in Asian, Jewish and Latin-American populations (11 studies; RR: 0.97; 95% CI: 0.83–1.13), with no evidence of heterogeneity across these ethnicities. Smokers were at reduced risk of UC (51 studies; RR: 0.55, 95% CI: 0.48–0.64; weak evidence) irrespectively of ethnicity; however, cohort studies, large studies and those recently published showed attenuated associations. Conclusions This meta-analysis did not identify any increased risk of CD in smokers in ethnicities other than non-Jewish Whites, and confirmed the protective effect of smoking on UC occurrence. Future research should characterize the genetic background of CD patients across different ethnicities to improve our understanding on the role of smoking in CD pathogenesis.

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