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BACKGROUND/OBJECTIVES: Studies on the associations between coffee and green tea consumption and arterial stiffness are rare. This study evaluated the possible relationships between coffee and green tea consumption and brachial-ankle pulse wave velocity (ba-PWV) values in Japanese men. SUBJECTS/METHODS: In total, 540 eligible men who enrolled in the baseline survey of a cohort study in Tokushima Prefecture, Japan, and who underwent ba-PWV measurement were analyzed. Information about lifestyle characteristics including coffee and green tea intake were obtained from a structural self-administered questionnaire. Multiple linear regression analyses were used to evaluate the associations between coffee and green tea consumption and ba-PWV. RESULTS: Subjects with greater coffee consumption were younger and showed higher proportions of current smoking and alcohol consumption. Subjects with greater green tea consumption were older and showed lower proportions of current smoking and alcohol consumption. Greater coffee consumption was significantly inversely associated with ba-PWV after the adjustment for probable covariates, including serum low-density lipoprotein cholesterol and high-density lipoprotein cholesterol (P for trend = 0.031). After additional adjustment for serum triglycerides, this inverse association persisted, but was somewhat attenuated (P for trend = 0.050). In contrast, green tea consumption was not associated with ba-PWV. CONCLUSIONS: Coffee consumption was inversely associated with arterial stiffness independent of known atherosclerotic risk factors, and this association was partly mediated by reduced circulating triglycerides. Further prospective or interventional studies are needed to confirm the causal association. European Journal of Clinical Nutrition (2013) 67, 1109-1114; doi: 10.1038/ejcn.2013.132; published online 17 July 2013 Keywords: arterial stiffness; pulse wave velocity; coffee; green tea; cross-sectional study, INTRODUCTION Cardiovascular events are major causes of death globally. Subjects with arterial atherosclerosis are at high risk for cardiovascular events. Atherosclerotic changes in the arteries mainly contribute to the pathogenesis [...]

Fermented foods refer to beverages or foods made by carefully regulated microbial growth and the enzymatic conversion of dietary components. Fermented foods have recently become more popular. Studies on fermented foods suggest the types of bacteria and bioactive peptides involved in this process, revealing linkages that may have impacts on human health. By identifying the bacteria and bioactive peptides involved in this process, studies on fermented foods suggest relationships that may have impressions on human health. Fermented foods have been associated with obesity, cardiovascular disease, and type 2 diabetes. In this article, fermented dairy products, vegetables and fruits, legumes, meats, and grains are included. Two elements in particular are emphasized when discussing the fermentation of all of these foods: bioactive chemicals generated during fermentation and microorganisms involved during fermentation. Organic acids, bioactive peptides, conjugated linoleic acid, biogenic amines, isoflavones, phytoestrogens, and nattokinase are a few of the bioactive compounds included in this review. Also, certain bacteria such as Lactobacillus, Bifidobacterium, Streptococcus, and Bacillus species, which are utilized in the fermentation process are mentioned. The effects of both substances including anti-fungal and antioxidant properties; the modulation of intestinal microbiota; anti-inflammatory, antidiabetes, anti-obesity, anticancer, and antihypertension properties; and the protection of cognitive function are explained in this review. [ABSTRACT FROM AUTHOR]

Garlic (Allium sativum) is an essential vegetable that has been widely utilized as seasoning, flavoring, culinary and in herbal remedies. Garlic contains several characteristic organosulfur compounds, such as diallyl sulfide, allicin (diallyl thiosulphate), γ-glutamylcysteine, and S-allyl cysteine (alliin) and ajoene, which garlic has beneficial effects on inflammation, oxidative stress markers, hypertension, hyperlipidaemia and endothelial function in vitro or in animal model. These bioactive molecules are also playing pivotal role in livestock and fisheries production apart from its application in humans. Supplementation of animal feed with garlic and its related products is consistent with the modern agricultural concept of organic animal husbandry. This review compiles the information describing the effects of feeding garlic and its extracts on selected performance parameters in animals (chicken, rabbits, ruminants, pigs and fish). This review may provide reference for scientists and entrepreneurs to investigate the applications of feeds added with garlic and allicin by-products for the improvement of animal husbandry and aquatic production. [ABSTRACT FROM AUTHOR]

Fucoidan is a sulphated polysaccharide isolated from brown seaweeds. It has attracted a lot of attention due to its multiple physiological and biological properties. The most dominant polysaccharides in brown seaweeds are laminarin and alginic acid. Fucoidan extracted from brown seaweed possess various biological functions including anti‐inflammatory, immunomodulatory, antitumour, antibacterial, antiviral, anticoagulant, antioxidant, neuroprotective, cardio‐protection and growth‐promoting effects. Dietary supplementation of fucoidan showed significant therapeutic influences on aquatic organisms, human, livestock and poultry. This review highlights the medicinal importance and nutritional values of fucoidan polysaccharides for fish, animals and humans, to be used as a natural agent for the treatment of various pathological disorders and to replace the synthetic antibiotics. Previously, most studies are focused on in vitro model and in mice. Further studies are warranted on in vivo model and focusing on a molecular basis to understand the mechanisms of action of fucoidan as an alternative therapeutic drug for fish, animals and humans. Another objective of this review is to give more light about the beneficial impacts of fucoidan on productive performance of animals and poultry as well as aquatic organisms. [ABSTRACT FROM AUTHOR]

Despite the abundant treatise and resource materials on Ramadan fasting, questions still arise regarding the benefits of this annual religious ritual. In an attempt to lend credence to the medical benefits of Ramadan, an academic adventure was undertaken, entailing the principles of Ramadan fasting and its effects on Muslims in terms of health and sickness. The findings of the studies on the health implications of Ramadan fasting and other similar prolonged dietary restrictions in human participants and animal models were reviewed and discussed. This review also catalogued the main contributions of fasting to the human health and physiological wellbeing of experimental subjects. In addition, our study considered religious limitations, as well as the side-effects and health hazards of some ailments that could pose a threat to Muslims, vis-à-vis their observance of Ramadan fasting. Some of the conditions that are inimical to the physiological status of human participants include cardiac diseases, diabetes mellitus, and pregnancy in women. Consistent with the previous findings, the present study indicated that Ramadan fasting has health, social, moral, environmental, and spiritual benefits for Muslims. In conclusion, fasting has proven an efficacious nutritherapy as the offered dietary regimens are among the non-pharmacological approaches to improving the human health with several societal and environmental benefits. In addition, Ramadan fasting leads to positive changes in the attitudes of individuals, thereby resulting in the sociocultural balance of the community and environmental harmony. [ABSTRACT FROM AUTHOR]

Target of rapamycin (TOR) is a highly conserved protein kinase that plays a key role in mediating cell growth and homeostasis. It is activated by nutrients, growth factors, and cellular energy levels to control a number of anabolic and catabolic processes. It is a validated drug target implicated in a variety of diseases. In this review, we describe the molecular mode of action of TOR in the context of cellular and organismal physiology. We focus on mammalian TOR (mTOR) signaling in cancer and neurological disease and discuss usage of TOR inhibitors in the clinic. [ABSTRACT FROM AUTHOR]

The article discusses the relationship between sleep status and diet quality and mortality in men and women. The results are based on the Elderly Nutrition and Health Survey in Taiwan (NAHSIT), conducted between 1999 and 2000 on 1865 elderly Taiwanese people, using results from a dietary diversity score (DDS) which analyzed food intake frequency and quality. Plasma pyridoxal phosphate (PLP), folate, and vitamin B-12 sufficiency are assessed along with the subjects' physical performance.

High desert dust concentrations raise concerns about adverse health effects on human populations. Based on a systematic literature review, this paper aims to learn more about the relationship between desert dust and human health in the world and to analyse the place of West Africa as a study area of interest. Papers focussing on the potential relationship between dust and health and showing quantitative analyses, published between January 1999 and September 2011, were identified using the ISI Web of Knowledge database ( N = 50). A number of adverse health effects, including respiratory, cardiovascular and cardiopulmonary diseases, are associated with dust. This survey highlights obvious dust impacts on human health independently of the study area, health outcomes and method. Moreover, it reveals an imbalance between the areas most exposed to dust and the areas most studied in terms of health effects. None of these studies has been conducted in West Africa, despite the proximity of the Sahara, which produces about half of the yearly global mineral dust. In view of the alarming results in many parts of the world (Asia, Europe, America), this paper concludes by stressing the importance of carrying out impact studies of Saharan dust in West Africa, where dust events are more frequent and intense than anywhere else. [ABSTRACT FROM AUTHOR]

Background: Micro- and nanoplastics (MNPs) and homosalate (HMS) are ubiquitous emerging environmental contaminants detected in human samples. Despite the well-established endocrine-disrupting effects (EDEs) of HMS, the interaction between MNPs and HMS and its impact on HMS-induced EDEs remain unclear. Objectives: This study aimed to investigate the influence of MNPs on HMS-induced estrogenic effects and elucidate the underlying mechanisms in vitro and in vivo. Methods: We assessed the impact of polystyrene nanospheres (PNSs; 50nm, 1.0mg/L) on HMS-induced MCF-7 cell proliferation (HMS: 0.01-1 [micro]M, equivalent to 2.62-262 [micro]g/L) using the E-SCREEN assay and explored potential mechanisms through transcriptomics. Adult zebrafish were exposed to HMS (0.0262-262 [micro]g/L) with or without PNSs (50nm, 1.0 mg/L) for 21 d. EDEs were evaluated through gonadal histopathology, fertility tests, steroid hormone synthesis, and gene expression changes in the hypothalamus-pituitary-gonad-liver (HPGL) axis. Results: Coexposure of HMS and PNSs resulted in higher expression of estrogen receptor a (ESR1) and the mRNAs of target genes (pS2, AREG, and PGR), a greater estrogen-responsive element transactivation activity, and synergistic stimulation on MCF-7 cell proliferation. Knockdown of serum and glucocorticoid-regulated kinase 1 (SGK1) rescued the MCF-7 cell proliferation induced by PNSs alone or in combination with HMS. In zebrafish, coexposure showed higher expression of SGK1 and promoted ovary development but inhibited spermatogenesis. In addition, coexposure led to lower egg hatchability, higher embryonic mortality, and greater larval malformation. Coexposure also modulated steroid hormone synthesis genes (cyp17a2, hsd17[beta]1, esr2b, vtgl, and vtg2), and resulted in higher 17[beta]-estradiol ([E.sub.2]) release in females. Conversely, males showed lower testosterone, [E.sub.2], and gene expressions of cyp11a1, cyp11a2, cyp17a1, cyp17a2, and hsd17[beta]1. Discussion: PNS exposure exacerbated HMS-induced estrogenic effects via SGK1 up- regulation in MCF-7 cells and disrupting the HPGL axis in zebrafish, with gender-specific patterns. This offers new mechanistic insights and health implications of MNP and contaminant coexposure. https://doi.org/10.1289/EHP13696, Introduction Escalating plastic pollution has emerged as a grave concern for both the environment and society. (1) Among the emerging contaminants, micro- and nanoplastics (MNPs) have garnered significant attention owing [...]

Background Encapsulating Peritoneal Sclerosis (EPS) is a rare phenomenon in paediatric patients with kidney failure treated with peritoneal dialysis (PD). This study highlights clinical challenges in the management of EPS, with particular emphasis on peri-operative considerations and surgical technique. Methods Retrospective analysis of all paediatric patients with EPS treated at the Manchester Centre for Transplantation. Results Four patients were included with a median duration of 78 months on PD. All patients had recurrent peritonitis (> 3 episodes), and all had symptoms within three months of a change of dialysis modality from PD to haemodialysis or transplant. In Manchester, care was delivered by a multi-disciplinary team, including surgeons delivering the adult EPS surgical service with a particular focus on nutritional optimisation, sepsis control, and wound management. The surgery involved laparotomy, lavage, and enterolysis of the small bowel + / - stoma formation, depending on intra-abdominal contamination. Two patients had a formal stoma, which were reversed at three and six months, respectively. Two patients underwent primary closure of the abdomen, whereas two patients had re-look procedures at 48 h with secondary closure. One patient had a post-operative wound infection, which was managed medically. One patient's stoma became detached, leading to an intra-abdominal collection requiring re-laparotomy. The median length of stay was 25 days, and patients were discharged once enteral feeding was established. All patients remained free of recurrence with normal gut function and currently two out of four have functioning transplants. Conclusions This series demonstrates 100% survival and parenteral feed independence following EPS surgery. Post-operative morbidity was common; however, with individualised experience-based decision-making and relevant additional interventions, patients made full recoveries. Health and development post-surgery continued, allowing the potential for transplantation. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information, Author(s): Videha Sharma [sup.1] , Zia Moinuddin [sup.1] , Angela Summers [sup.1] , Mohan Shenoy [sup.2] , Nicholas Plant [sup.2] , Semir Vranic [sup.3] [sup.4] , Agnieszka Prytula [sup.5] , [...]

Background/objectives The association of fermented soy products, separately from total soy products, with cardiovascular disease (CVD) and total cancer has not been reported. We examined this association in a population-based prospective cohort study in Japan. Subjects/methods We studied 79,648 participants (42,788 women; 36,860 men) aged 45-74 years without a history of cancer, myocardial infarction, or stroke. Participants completed a food frequency questionnaire (1995-1998) and were followed to 2009-2012. Cox proportional hazards regression analysis was used to calculate the hazard ratios (HR) and 95% confidence intervals (CI) of incidence of CVD and total cancer according to quartiles of total soy products, nonfermented soy products, fermented soy products, miso soup, natto, total isoflavones from soy products, isoflavones from nonfermented soy products, and isoflavones from fermented soy products. Results In women, we observed a significant inverse association between fermented soy product intake and the risk of CVD (multivariate HR in the highest compared with the lowest quartile of fermented soy product intake: 0.80; 95% CI: 0.68, 0.95; P for trend = 0.010), and also found significant inverse associations for natto and isoflavones among fermented soy products. In site-specific analysis, we observed a similar, significant inverse association between fermented soy product intake and the risk of stroke in women. We found no significant association between any soy product and risk of CVD in men or total cancer in both sexes. Conclusions Intake of fermented soy products such as natto was inversely associated with the risk of CVD in women., Author(s): Miho Nozue [sup.1] [sup.2] , Taichi Shimazu [sup.2] , Hadrien Charvat [sup.2] , Nagisa Mori [sup.2] , Michihiro Mutoh [sup.2] , Norie Sawada [sup.2] , Motoki Iwasaki [sup.2] , [...]

There has been much interest in the potential role of soy in reducing the risk of chronic diseases. Soy foods are uniquely rich in isoflavones, a fact that has triggered much research including intervention studies. However, there have been few long-term prospective observational studies that include disease itself as an outcome. High intake of soy foods is intrinsic to the Japanese diet, which can be advantageous for conducting such studies in Japan. The present report reviews the findings from Japanese prospective cohort studies on soy intake and the risk of cardiovascular diseases, cancer, type 2 diabetes, osteoporosis, menopausal symptoms, and dementia. The results suggest a beneficial role of soy in several chronic diseases, but they are not without controversy. Discrepancies have been observed in the findings of studies of Japanese or other Asians as compared to those of non Asians. This review discusses the issues to be explored in future studies., Author(s): Chisato Nagata [sup.1] Author Affiliations: (1) Department of Epidemiology & Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan Introduction Epidemiological studies have shown a lower incidence of [...]

Background/Objectives Dietary habits are known to affect health, including the rate of brain ageing and susceptibility to diseases. This study examines the longitudinal relationship between dietary diversity and hippocampal volume, which is a key structure of memory processing and is known to be impaired in dementia. Subjects/Methods Subjects were aged 40-89 years (n = 1683, men: 50.6%) and participated in a 2-year follow-up study of the National Institute for Longevity Sciences-Longitudinal Study of Aging. Dietary intake was calculated from 3-day dietary records, and dietary diversity was determined using the Quantitative Index for Dietary Diversity at baseline. Longitudinal changes in hippocampal and total grey matter volumes were estimated by T1-weighted brain magnetic resonance imaging and FreeSurfer software. Estimated mean brain volume change in relation to dietary diversity score quintiles was assessed by the general linear model, adjusted for age, sex, education, smoking status, alcohol intake, physical activity, and comorbidities. Results The mean ([plus or minus] standard deviation) % decreases in hippocampal and total grey matter volume during the 2-year follow-up were 1.00% ([plus or minus]2.27%) and 0.78% ([plus or minus]1.83%), respectively. Multivariate-adjusted decreases in total grey matter volume were associated with dietary diversity score (p = 0.065, p for trend = 0.017), and the % decrease in hippocampal volume was more strongly associated with the dietary diversity score: the estimated mean ([plus or minus] standard error) values were 1.31% ([plus or minus]0.12%), 1.07% ([plus or minus]0.12%), 0.98% ([plus or minus]0.12%), 0.81% ([plus or minus]0.12%), and 0.85% ([plus or minus]0.12%), according to dietary diversity quintiles in ascending order (p = 0.030, p for trend = 0.003). Conclusions Among community dwellers, increased dietary diversity may be a new nutritional strategy to prevent hippocampal atrophy., Author(s): Rei Otsuka [sup.1] , Yukiko Nishita [sup.2] , Akinori Nakamura [sup.3] , Takashi Kato [sup.3] , Kaori Iwata [sup.3] , Chikako Tange [sup.1] , Makiko Tomida [sup.1] , Kaori [...]

With the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Wuhan, China, several countries, including Japan, repatriated their nationals (1-3). During January 29-31, 2020, a total of 566 [...]

Background/Objectives Although dietary calcium intake is associated with a risk of cardiovascular disease (CVD), it has not been studied extensively in Asian populations. We therefore investigated the association between dietary calcium intake and CVD among Korean adults and the effect of obesity on this association. Subjects/Methods In total, 9186 participants were included in the analysis after excluding 844 with prevalent CVD/cancer or implausible energy intake. Nutrient intake, including dietary calcium, was estimated using a validated semi-quantitative food frequency questionnaire. CVD included myocardial infarction, coronary artery disease, and stroke per the World Health Organization criteria. Cox proportional hazards models were used to calculate multivariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). Results In the fully adjusted model, HRs of CVD across increasing quintiles of dietary calcium intake were 1.0 (reference), 0.85 (95% CI: 0.66-1.10), 0.77 (95% CI: 0.58-1.02), 0.59 (95% CI: 0.42-0.83), and 0.72 (95% CI: 0.48-1.08); a significant linear trend was detected (p for trend = 0.04). However, this association varied according to the obesity status. High dietary calcium intake was associated with a reduced CVD risk among nonobese participants (body mass index [BMI] < 25 kg/m.sup.2; p for trend = 0.02), whereas this was not significant among obese participants (BMI [greater than or equal to] 25 kg/m.sup.2; p for trend = 0.88). Conclusions The association between dietary calcium intake and incident CVD may be influenced by obesity status. We provide evidence for developing dietary calcium intake guidelines for Koreans, allowing for the effects of obesity., Author(s): M. J. Chae [sup.1], J. Y. Jang [sup.1], K. Park [sup.1] Author Affiliations: (1) Department of Food and Nutrition, Yeungnam University, Gyeongsan, Gyeongbuk, Republic of Korea Introduction Cardiovascular disease [...]

Strongyloidiasis is a nematode infection caused by Strongyloides stercoralis, a parasitic roundworm. Parasites of the genus S. stercoralis are characteristic for their ability to replicate within hosts (1). Patients have [...]

Background/Objectives: Animal studies have demonstrated that soy isoflavones exert antidiabetic effects. However, evidence regarding the association between soyfood intake, a unique source of isoflavones, and type 2 diabetes remains inconclusive. This study assessed the relationship between habitual intakes of soyfoods and major isoflavones and risk of type 2 diabetes in Vietnamese adults. Subjects/Methods: A hospital-based case-control study was conducted in Vietnam during 2013-2015. A total of 599 newly diagnosed diabetic cases (age 40-65 years) and 599 hospital-based controls, frequency matched by age and sex, were recruited in Hanoi, capital city of Vietnam. Information on frequency and quantity of soyfood and isoflavone intake, together with demographics, habitual diet and lifestyle characteristics, was obtained from direct interviews using a validated and reliable questionnaire. Unconditional logistic regression analyses were performed to examine the association between soy variables and type 2 diabetes risk. Results: Higher intake of total soyfoods was significantly associated with a lower risk of type 2 diabetes; the adjusted odds ratio (OR) for the highest versus the lowest intake was 0.31 (95% confidence interval (CI): 0.21-0.46; P Conclusions: Soyfood and isoflavone intake was associated with a lower type 2 diabetes risk in Vietnamese adults., Author(s): C T Nguyen [sup.1] [sup.2] , N M Pham [sup.1] [sup.3] , V V Do [sup.1] , C W Binns [sup.1] , V M Hoang [sup.4] , D A [...]

Byline: Maria. Chatrasingh, Jackrit. Suthakorn Background: Freehand ultrasound (US) is a technique used to acquire three-dimensional (3D) US images using a tracked 2D US probe. Calibrating the probe with a [...]

Background/Objectives The prolongation of healthy life expectancy (HALE) is a core issue of health policy in many countries. The purpose of this study is to clarify the relationship between dietary diversity and HALE using international databases. Materials/Methods HALE data by country were derived from the Global Burden of Disease (GBD) 2015 database. Average food supply (g/day/capita) and energy supply (kcal/day/capita) by country, excluding loss between production and household, were obtained from the Food and Agriculture Organization of the United Nations Statistics Division database. Each food was sorted across 12 food groups, and dietary diversity was obtained from food groups using the Quantitative Index for Dietary Diversity (QUANTIDD). The cross-sectional and longitudinal associations between QUANTIDD and HALE were examined in the countries with populations of one million or greater. Results Cross-sectional analysis showed that HALE was significantly associated with QUANTIDD ([beta] = 99.9 [plus or minus] 11.4, p < 0.001) in the single regression model and in the multiple regression model controlled for covariates ([beta] = 36.4 [plus or minus] 11.3, p = 0.002). Longitudinal analysis showed that HALE increased with QUANTIDD during the 15-year study period ([beta] = 46.4 [plus or minus] 5.1, p < 0.001), and this association was also significant when controlled for covariates ([beta] = 39.7 [plus or minus] 5.1, p < 0.001). Longitudinal association of QUANTIDD with the percentage difference between life expectancy and HALE controlled for covariates was significantly negative ([beta] = - 1.3 [plus or minus] 0.5, p = 0.011). Conclusions After controlling for socioeconomic indicators, longer healthy life is enjoyed by populations of countries with greater dietary diversity., Author(s): Keiko Miyamoto [sup.1] , Fumiya Kawase [sup.1] , Tomoko Imai [sup.2] , Ayako Sezaki [sup.2] , Hiroshi Shimokata [sup.1] Author Affiliations: (1) Graduate School of Nutritional Science, Nagoya University [...]

Despite technological improvements in dialysis connectology and dialysis technique, peritonitis remains the most common and most significant complication of peritoneal dialysis (PD) in children. Most children undergoing chronic PD experience none or only one peritonitis episode, while others have multiple episodes or episodes secondary to unusual organisms. Knowledge of potential risk factors and likely patient outcome is imperative if treatment is to be optimized. In this review we will, in turn, describe episodes of peritonitis that are characterized as either relapsing, recurrent, repeat or zoonosis-related to highlight the clinical issues that are commonly encountered by clinicians treating these infections., Author(s): Sevcan A. Bakkaloglu[sup.1] , Bradley A. Warady[sup.2] Author Affiliations: (1) Department of Pediatrics, Division of Pediatric Nephrology, Gazi University School of Medicine, Ankara, Turkey (2) Division of Pediatric Nephrology, [...]

ABSTRACT Background: Our previous study reveals that total rough extract of Radix Scrophulariae has a beneficial effect on ventricular remodeling. Hypothesis: After carrying out a series of preliminary experiments, we [...]

The inherited tubulopathies are lifelong disorders and their clinical features and complications may present quite different challenges in adulthood from those in childhood. In this review we outline the pathophysiology and documented complications (including the late and unusual) of the monogenic tubulopathies from the perspective of the adult nephrologist. Keywords Tubulopathy * Electrolytes * Acid-based * Inherited renal disease * Adult nephrology * Genetics, Introduction There can be considerable overlap in the presentations of paediatric and adult patients with inherited tubular disease. Inevitably there are also important differences in emphasis for clinicians, and challenges [...]

Background Encapsulating peritoneal sclerosis (EPS) is a serious complication of long-term peritoneal dialysis (PD), but only a few cases have been described in the pediatric patient population. There is no established medical treatment, and surgery has been reported with variable success. The number of reports of EPS being successfully treated with tamoxifen, based on its anti-fibrotic effects, are increasing. The role of sirolimus, an mTOR inhibitor with immunomodulatory and anti-proliferative properties, has been less well-defined. Case-Diagnosis/Treatment A 17-year-old kidney transplant recipient, with a previous cumulative time on PD of 8 years and 3 months, developed severe bowel obstruction 8 months after undergoing a second kidney graft. Her immunosuppressive regimen consisted of tacrolimus, mycophenolate mofetil, and prednisolone. The patient underwent laparotomy, which revealed multiple thick leathery adhesions with an encapsulated small bowel. Enterolysis was performed, and total parenteral nutrition was commenced after surgery to provide an adequate food intake. Treatment with tamoxifen was initiated, but the patient developed significant liver toxicity 2 weeks later, and the drug was withdrawn. The immunosuppressive regimen was changed to an increased dose of prednisolone, and tacrolimus was replaced with sirolimos. At 20 months of follow-up, the patient remains symptom-free, with a functioning kidney transplant. Conclusion Although EPS is a very rare condition in the pediatric population, it should be considered when a child or adolescent with a long-term history of PD presents with nonspecific gastrointestinal symptoms or with signs of bowel obstruction. There is an urgent need for alternative immunosuppressive protocols. The use of sirolimus in this group of patients remains controversial, Introduction Encapsulating peritoneal sclerosis (EPS) is a serious, long-term complication of peritoneal dialysis (PD), first described in 1978 by Gandhi et al. [1]. The condition is characterized by intestinal obstruction [...]

ARTICLE INFO Keywords: Radix Scrophulariae Ethanolic extract Rat Coronary artery ligation Ventricular remodeling ABSTRACT Purpose: To explore the effects of ethanolic extract of Radix Scrophulariae (EERS) on ventricular remodeling in [...]

Randomized controlled trails (RCTs) where cetuximab added to first-line platinum-based chemotherapy for patients with advanced/metastatic non-small-cell lung cancer (NSCLC) have yielded conflicting results. This meta-analysis intended to evaluate the efficacy and safety of cetuximab-based therapy (CBT) in that setting. We analyzed four eligible RCTs that included 1,003 and 1,015 patients randomized to CBT and control intervention, respectively. As compared with the noncetuximab group, CBT demonstrated an 9% reduction in the risk of disease progression [hazard ratio (HR) = 0.91; (CI = 0.83-1.00); p = 0.06], a 13% reduction in the risk of death [HR = 0.87; (CI = 0.78-0.96); p = 0.005], and an approximately 50% increase in objective response rate [odds ratio (OR) = 1.48; (CI = 1.22-1.80); p < 0.0001]. CBT-related adverse events were similar across comparisons except for toxicities known to be associated with anti-EGFR therapy. CBT produced significant clinical benefit with acceptable toxicity as a first-line strategy in patients with advanced/metastatic NSCLC. Further research is needed to identify markers predictive of cetuximab benefit in that disease. Keywords Lung cancer * Cetuximab * EGFR * Meta-analysis, Introduction Lung cancer is the most frequent cause of cancer death [1]. The overall prognosis remains poor, with 15% of patients surviving 5 years [2]. Patients with advanced non-small-cell lung [...]

Hypokalemia is a recognized cause of rhabdomyolysis but very few reports document its association with inborn renal tubular disorders. We report our experience with hypokalemic rhabdomyolysis in 5 pediatric patients affected by inborn renal tubular disorders and the results of a careful review of the literature disclosing 9 further cases for a total of 14 patients (8 male and 6 female subjects, aged between 1.6 and 46, median 16 years). The inborn renal tubular disorders underlying rhabdomyolysis were classic distal renal tubular acidosis (n =7), Gitelman syndrome (n=5), classic Bartter syndrome (n =1), and antenatal Bartter syndrome (n =1). In 8 patients rhabdo myolysis followed an acute intestinal disease, an upper respiratory illness or the discontinuation of regular medication. Five patients experienced two or more episodes of rhabdomyolysis. In 10 patients the underlying renal tubular disorder was recognized concurrently with the episode of rhabdomyolysis or some weeks later. In conclusion some congenital renal tubular disorders predispose to hypokalemic rhabdomyolysis. Prevention of discontinuation of regular medication and electrolyte repair in the context of acute intercurrent illnesses might avoid the development of hypokalemic rhabdomyolysis. Keywords Bartter syndrome * Distal renal tubular acidosis * Gitelman syndrome * Hypokalemia * Rhabdomyolysis, Introduction Rhabdomyolysis is the abrupt breakdown of skeletal muscle fibers resulting in the release of muscle content into the circulation [1-4]. The increased blood concentration of creatine kinase to more [...]

Encapsulating peritoneal sclerosis (EPS) is the most serious complication of long-term peritoneal dialysis (PD), with a mortality rate that exceeds 30%. There have been many reports of the incidence of EPS being strongly correlated to the duration of PD. Patients on PD for longer than 5 years, and especially those receiving this treatment for more than 8 years, should undergo careful and repeated surveillance for risk factors associated with the development of EPS. The development of ultrafiltration failure, a high dialysate/plasma creatinine ratio, as determined by the peritoneal equilibration test, peritoneal calcification, a persistently elevated C-reactive protein level, and severe peritonitis in patients on PD for longer than 8 years are signals that should prompt the clinician to consider terminating PD as a possible means of preventing the development of EPS. The impact of the newer, biocompatible PD solutions on the incidence of EPS has not yet been determined., Author(s): Masataka Honda [sup.1] , Bradley A. Warady [sup.2] Author Affiliations: (1) grid.417084.e, 0000 0004 1764 9914, Department of Pediatric Nephrology, Tokyo Metropolitan Children's Hospital, , Umezono 1-3-1, 204-8567, Kiyoseshi, [...]

Despite their highly varied histories, profound rhabdomyolysis developed in each of the critically ill patients described in the 'Patient Profiles' (see box). What is rhabdomyolysis? Why does it occur in [...]

We report here the first published case of a pediatric patient with Gitelman's syndrome (GS) in whom hypokalemia-associated rhabdomyolysis developed. A 13-year-old girl was admitted with weakness of the extremities, walking difficulty and calf pain. Laboratory data showed a serum potassium level of 2.1 mmol/l and a serum creatinine phosphokinase level of 1,248 IU/l plus myoglobinemia. The presence of normomagnesemia was the basis for a genetic analysis of the thiazide-sensitive sodium chloride cotransporter gene, which revealed compound heterozygous mutations in this gene. Prompt fluid expansion and potassium supplementation led to regression of the muscle symptoms. Hypokalemia can be a rare cause of rhabdomyolysis in patients with GS, even in childhood. We emphasize that genetic analysis is advisable to determine whether the suspicion of GS is warranted. Keywords Creatinine phosphokinase * Gitelman's syndrome * Hypokalemia * NCCT * SLC12A3, Introduction Gitelman's syndrome (GS) is an autosomal recessive renal disorder first described by Gitelman, Graham, and Welt in 1966 [1]. This syndrome, characterized by hypokalemia, hypomagnesemia, metabolic alkalosis, and hypocalciuria, [...]

Byline: Raed. Azhar, Inderbir. Gill, Monish. Aron There have been a number of advances in robotic partial nephrectomy (RPN) for renal masses. We reviewed these advances with emphasis on the [...]

Byline: Sangeeta. Ravat, Rohit. Gupta The epilepsies are socially handicapping disorders and even a single seizure occurring in certain circumstances may have disastrous effect. The impact of epilepsy on every [...]