Assessment of the Nutritional Profile of Women with Breast Cancer from the Agadir Region (South of Morocco)

Background: Although the incidence of breast cancer and the resulting mortality are very high in Morocco, no study has been carried out on the role of the nutritional factors in the development of BC. Objective: The objective of this study was to assess the nutritional profile of women with BC in southern Morocco Methods: The study was conducted with 91 women with breast cancer. Face-to-face semi-structured interviews were used for the assessment of the nutritional profile and the collection of socio-economic data. Biometric measures were carried out in parallel. Results: The results showed that postmenopausal women had a significantly higher mean weight and Body Mass Index than non-menopausal women (p < 0.015). The majority of patients (79%) had energy intakes above recommendations. The proportion of lipids was excessive in 46% of cases. Intakes of saturated fatty acids were high in 14% of patients. But those of unsaturated fatty acids were high in over 50% of patients. About 58 % had a very high intake of fast sugars. Cholesterol input was high in 40% of cases. Vitamins A, E and D were provided in small amounts, respectively in 66%, 45% and 91% of patients. Likewise, intakes were low for water-soluble vitamins, especially Vitamins B9 (62.6%) and B12 (54%). Almost the majority of participants in our study (92%) had very low calcium intakes. Inputs of magnesium, zinc and selenium were insufficient in 43%, 35% and 48% of patients respectively. Conclusion: Obesity, excessive energy and sugar intake, as well as mineral and vitamin deficiencies could explain the high incidence of breast cancer in southern Morocco. A balanced diet would fight against breast cancer.

PREVALENCE OF FAT-SOLUBLE VITAMIN DEFICIENCIES ASSOCIATED WITH SEVERE ACUTE MALNUTRITION: A PROSPECTIVE OBSERVATIONAL STUDY

Background: Severe acute malnutrition (SAM), among children below five years of age is global health problem contributing to childhood morbidity, mortality and remains a major embarrassment to optimal human capital development in India. Objectives: Study aim was to accesses fat soluble vitamins deficiencies among children with SAM and outcomes after treatments with F-75/F-100 plus vitamins mix. Methods: The study was prospective observational conducted in the nutritional rehabilitation center (NRC) at district general hospital for 6 months. Anthropometric measurements were taken to determine their nutritional status. Results: 100 patients of NRC were enrolled in the study. Sixty nine percent (69) patients had weight/height (WT/HT) Z score<−3 standard deviation (3 SD), 16 % with Z score<−2 and 15% of them had Z score<−4 malnutrition. Out of 100 children, 46% children were males, and 56% children were females. Vitamin E deficiencies (54%) were highly prevalent in hospitalized SAM groups, followed by 28% vitamin D and 18% were vitamin A deficient. Conclusion: Micronutrient deficiencies were highly prevalent with fat soluble vitamins and recovered on application of WHO protocols during hospitalization induced satisfactory fat-soluble vitamin status recovery significant (p<0.05).

One-carbon metabolism during the menstrual cycle and pregnancy

Many enzymes in one-carbon metabolism (OCM) are up- or down-regulated by the sex hormones which vary diurnally and throughout the menstrual cycle. During pregnancy, estradiol and progesterone levels increase tremendously to modulate physiological changes in the reproductive system. In this work, we extend and improve an existing mathematical model of hepatic OCM to understand the dynamic metabolic changes that happen during the menstrual cycle and pregnancy due to estradiol variation. In particular, we add the polyamine drain on S-adenosyl methionine and the direct effects of estradiol on the enzymes cystathionine β-synthase (CBS), thymidylate synthase (TS), and dihydrofolate reductase (DHFR). We show that the homocysteine concentration varies inversely with estradiol concentration, discuss the fluctuations in 14 other one-carbon metabolites and velocities throughout the menstrual cycle, and draw comparisons with the literature. We then use the model to study the effects of vitamin B12, vitamin B6, and folate deficiencies and explain why homocysteine is not a good biomarker for vitamin deficiencies. Additionally, we compute homocysteine throughout pregnancy, and compare the results with experimental data. Our mathematical model explains how numerous homeostatic mechanisms in OCM function and provides new insights into how homocysteine and its deleterious effects are influenced by estradiol. The mathematical model can be used by others for further in silico experiments on changes in one-carbon metabolism during the menstrual cycle and pregnancy.

Keratodermia

В статье освещены сведения о кератодермиях – гетерогенной группе состояний, характеризующихся аномальным утолщением кожи ладоней и подошв. Традиционно выделяют приобретенные и наследственные формы. В клинической практике наиболее часто встречается гиперкератоз ладоней и подошв как одно из проявлений псориаза, экземы, дерматомикозов и многих других заболеваний. К развитию гиперкератоза ладоней и подошв могут также привести механические и токсические факторы (в том числе прием лекарственных препаратов), поступление с пищей токсических веществ, приводящих к изменениям слизистой кишечника, современные требования моды и красоты могут способствовать развитию множественного дефицита витаминов. Значительно реже встречаются наследственные формы кератодермий, являющиеся самостоятельными заболеваниями. Раннее начало и семейный анамнез предполагают генетическую природу кератодермии. Отличительными особенностями наследственных форм служат характер наследования, степень поражения эпидермиса, наличие/отсутствие распространения очагов за пределы кожи ладоней и подошв, сопутствующая патология. В основе развития наследственных форм лежат мутации различных генов, кодирующих белки (например, кератин, десмосомы, лорикрин, катепсин С, белки щелевых контактов), которые принимают участие в процессе кератинизации. Наследственные ладонно-подошвенные кератодермии имеют большую генетическую и фенотипическую неоднородность, вследствие чего постановка точного диагноза на основе одних лишь клинических проявлений, когда нет возможности выполнить молекулярно-генетическое исследование, является весьма сложной задачей. Благодаря секвенированию нового поколения был достигнут значительный прогресс в расшифровке генетической основы кератодермий. В данном обзоре рассмотрены патогенетические, клинические, диагностические особенности диффузных форм кератодермий, варианты симптоматической терапии, учитывая торпидность и резистентность патологического процесса. The article covers information about keratodermia, a heterogeneous group of conditions characterized by abnormal thickening of the skin of the palms and soles. Traditionally, acquired and hereditary forms are distinguished. In clinical practice, the most common hyperkeratosis of the palms and soles, as one of the manifestations of psoriasis, eczema, dermatomycosis and many other diseases. Mechanical and toxic factors (including taking medications), intake of toxic substances with food that lead to changes in the intestinal mucosa can also lead to the development of hyperkeratosis of the palms and soles, modern fashion and beauty requirements can contribute to the development of multiple vitamin deficiencies. Much less common are hereditary forms of keratoderma, which are independent diseases. Early onset, the presence of a positive family history suggest a genetic nature. The distinctive features of hereditary forms are the nature of inheritance, the degree of damage to the epidermis, the presence/absence of the spread of foci beyond the skin of the palms and soles, and concomitant pathology. The development of hereditary forms is based on mutations of various genes encoding proteins (for example, keratin, desmosomes, loricrin, cathepsin C, gap junction proteins), which are involved in the process of keratinization. Hereditary palmoplantar keratoderma has a large genetic and phenotypic heterogeneity, as a result of which making an accurate diagnosis based on clinical manifestations alone, when it is not possible to perform molecular genetic research, is a very difficult task. Thanks to the next-generation sequencing, significant progress has been made in deciphering the genetic basis of keratoderms. This review examines the pathogenetic, clinical, and diagnostic features of diffuse forms of keratoderma, and options for symptomatic therapy, taking into account the torpidity and resistance of the pathological process.

Secondary Malnutrition and Nutritional Intervention in Cholestatic Liver Diseases in Infants

We aimed to conduct an updated review on the pathophysiology, diagnosis, and nutritional intervention of CCLD and secondary malnutrition in infants. Protein-energy malnutrition, impaired linear growth, fat-soluble vitamin deficiencies, and hepatic osteodystrophy can occur in up to 80% of cases. The proposed pathophysiological mechanisms include insufficient energy intake, lipid- and fat-soluble vitamin malabsorption, increased energy expenditure, altered intermediate metabolism, hormonal dysregulation, and systemic inflammation. The current approach to diagnosis is the identification of the deviation of growth parameters, body composition, and serum concentration of micronutrients, which determines the type and magnitude of malnutrition. Currently, liver transplantation is the best therapeutic alternative for the reversal of nutritional impairment. Early and effective portoenteroanatomosis can extend survival in patients with biliary atresia. Medical and dietary interventions in some storage and metabolic diseases can improve liver damage and thus the nutritional status. A proportion of patients with biliary atresia have fat-soluble vitamin deficiencies despite receiving these vitamins in a water-soluble form. With aggressive enteral nutrition, it may be possible to increase fat stores and preserve muscle mass and growth. The nutritional issues identified in the pre- and post-transplantation stages include muscle mass loss, bone demineralization, growth retardation, and obesity, which seems to correspond to the natural history of CCLD. Due to the implications for the growth and development of infants with CCLD with this complex malnutrition syndrome, innovative projects are required, such as the generation of prediction and risk models, biomarkers of growth and body composition, and effective strategies for nutritional prevention and intervention.

The Role of Vitamin Deficiency in Liver Disease: To Supplement or Not Supplement?

Over the past few years, growing interest has been shown for the impact of dietary requirements and nutritional factors on chronic diseases. As a result, nutritional programs have been reinforced by public health policies. The precise role of micronutrients in chronic liver disease is currently receiving particular attention since abnormalities in vitamin levels are often detected. At present, treatment programs are focused on correcting vitamin deficiencies, which are frequently correlated to higher rates of comorbidities with poor outcomes. The literature reviewed here indicates that liver diseases are often related to vitamin disorders, due to both liver impairment and abnormal intake. More specific knowledge about the role of vitamins in liver disease is currently emerging from various results and recent evidence. The most significant benefits in this area may be observed when improved vitamin intake is combined with a pharmacological treatment that may also affect the progression of the liver disease, especially in the case of liver tumors. However, further studies are needed.

Alcohol and the Brain

Alcohol works on the brain to produce its desired effects, e.g., sociability and intoxication, and hence the brain is an important organ for exploring subsequent harms. These come in many different forms such as the consequences of damage during intoxication, e.g., from falls and fights, damage from withdrawal, damage from the toxicity of alcohol and its metabolites and altered brain structure and function with implications for behavioral processes such as craving and addiction. On top of that are peripheral factors that compound brain damage such as poor diet, vitamin deficiencies leading to Wernicke-Korsakoff syndrome. Prenatal alcohol exposure can also have a profound impact on brain development and lead to irremediable changes of fetal alcohol syndrome. This chapter briefly reviews aspects of these with a particular focus on recent brain imaging results. Cardiovascular effects of alcohol that lead to brain pathology are not covered as they are dealt with elsewhere in the volume.