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Introduction: The acquired immunodeficiency syndrome is a chronic, progressive, and degenerative disease. Since the introduction of antiretroviral therapy (ART), a significant reduction in mortality and morbidity rates has been recorded. However, patients may present cardiometabolic changes throughout the treatment. Objective: To assess the clinical and nutritional profile of HIV patients treated in a referral hospital in northeast Brazil. Methods: Descriptive cross-sectional study performed in inpatient and outpatient units for infectious and parasitic diseases at the Hospital of the Universidade Federal de Pernambuco Nutritional and clinical variables were assessed. The sample was a non-probabilistic convenience sample. The data were entered into Excel for Windows® and analyzed using SPSS® software (version 13.0), with a 5% level of significance set for the rejection of the null hypothesis. Results: In total, 110 patients were assessed (54.5% in infirmary). The mean age was 39±11 years, with15.4% of the individuals aged 50 years or more. Of the total, 64.5% were male. Among the patients in the ward, 52.5% had metabolic complications; 1.6% had lipodystrophy, and 15% had wasting syndrome, while ambulatory patients showed values of 76%, 4%, and 4%, respectively. Time of diagnosis, indication, time, and adherence to ART showed no differences between the groups. Conclusion: The metabolic changes related to cardiovascular risk factors and the preservation of nutritional status prevailed in ambulatory patients, while the clinical-nutritional profile of hospitalized patients showed energy-protein malnutrition as the most common complication, with greater involvement of the immune system and increased frequency of opportunistic infections and gastrointestinal symptoms. The use of licit and/or illicit drugs, the lack of knowledge about the importance of medication, and the negligence in care were the main reasons for the irregular use of ART.

Myopathy with extrapyramidal signs (MPXPS) is a rarely reported entity worldwide, manifesting as a muscular dystrophy with movement disorders. It results from mutations in the mitochondrial calcium uptake 1 (MICU1) gene. We hereby describe a 17-year-old boy who presented with proximal myopathy, calf muscle hypertrophy, and skeletal deformities along with choreiform movements of his upper extremities. Muscle MRI revealed a distinctively early involvement of adductors with sparing of antero-lateral compartment of thigh. This report expands the clinico-radiological presentation and to the best of our knowledge, is the first report of MICU-related MPXPS from India. [ABSTRACT FROM AUTHOR]

The ERK1/2 MAPK signalling module integrates extracellular cues that induce proliferation and differentiation of epithelial lineages, and is an established oncogenic driver, particularly in the intestine. However, the interrelation of the ERK1/2 module relative to other signalling pathways in intestinal epithelial cells and colorectal cancer (CRC) is unclear. Here we show that loss of Erk1/2 in intestinal epithelial cells results in defects in nutrient absorption, epithelial cell migration and secretory cell differentiation. However, intestinal epithelial cell proliferation is not impeded, implying compensatory mechanisms. Genetic deletion of Erk1/2 or pharmacological targeting of MEK1/2 results in supraphysiological activity of the ERK5 pathway. Furthermore, targeting both pathways causes a more effective suppression of cell proliferation in murine intestinal organoids and human CRC lines. These results suggest that ERK5 provides a common bypass route in intestinal epithelial cells, which rescues cell proliferation upon abrogation of ERK1/2 signalling, with therapeutic implications in CRC.

BackgroundSevere dermatitis, multiple allergies, and metabolic wasting (SAM) syndrome is a recently recognized syndrome caused by mutations in the desmoglein 1 gene (DSG1). To date, only 3 families have been reported.ObjectiveWe studied a new case of SAM syndrome known to have no mutations in DSG1 to detail the clinical, histopathologic, immunofluorescent, and ultrastructural phenotype and to identify the underlying molecular mechanisms in this rare genodermatosis.MethodsHistopathologic, electron microscopy, and immunofluorescent studies were performed. Whole-exome sequencing data were interrogated for mutations in desmosomal and other skin structural genes, followed by Sanger sequencing of candidate genes in the patient and his parents.ResultsNo mutations were identified in DSG1; however, a novel de novo heterozygous missense c.1757A>C mutation in the desmoplakin gene (DSP) was identified in the patient, predicting the amino acid substitution p.His586Pro in the desmoplakin polypeptide.ConclusionsSAM syndrome can be caused by mutations in both DSG1 and DSP. Knowledge of this genetic heterogeneity is important for both analysis of patients and genetic counseling of families. This condition and these observations reinforce the importance of heritable skin barrier defects, in this case desmosomal proteins, in the pathogenesis of atopic disease.

The keystone species Pisaster ochraceus suffered mass mortalities along the northeast Pacific Ocean from Sea Star Wasting Syndrome (SSWS) outbreaks in 2013–2016. SSWS causation remains of debate, leading to concerns as to whether outbreaks will continue to impact this species. Considering the apparent link between ocean temperature and SSWS, the future of this species and intertidal communities remains uncertain. Surveys of co‐occurring apparently normal and wasting P. ochraceus along the central Oregon coast in 2016 allowed us to address whether variation in disease status showed genetic variation that may be associated with differences in susceptibility to SSWS. We performed restriction site‐associated DNA sequencing (2bRAD‐seq) to genotype ~72,000 single nucleotide polymorphism (SNP) loci across apparently normal and wasting sea stars. Locus‐specific analyses of differentiation (FST) between disease‐status groups revealed no signal of genetic differences separating the two groups. Using a multivariate approach, we observed weak separation between the groups, but identified 18 SNP loci showing highest discriminatory power between the groups and scanned the genome annotation for linked genes. A total of 34 protein‐coding genes were found to be located within 15 kb (measured by linkage disequilibrium decay) of at least one of the 18 SNPs, and 30 of these genes had homologies to annotated protein databases. Our results suggest that the likelihood of developing SSWS symptoms does not have a strong genetic basis. The few genomic regions highlighted had only modest levels of differentiation, but the genes associated with these regions may form the basis for functional studies aiming to understand disease progression. [ABSTRACT FROM AUTHOR]

In China, the prevalence of undernutrition among children under 5 years of age has declined significantly during recent decades. However, noticeable gaps exist between rural and urban areas. Since 2012, a government‐funded nutrition programme, Ying Yang Bao (YYB; soybean powder‐based iron‐rich supplement) programme, has been implemented in poor rural areas to decrease the risk of developing anaemia among children aged 6–23 months, but there are still inadequate health care awareness, feeding knowledge and skills among caregivers. From June 2018 to December 2020, a child health counselling intervention was delivered through a home visit based on the YYB programme in Liangshan. Child health messages were given by trained village child health assistants while distributing YYB. Surveys were conducted before and after the intervention to analyse changes in child health check‐up frequency, complementary feeding practice and prevalence of undernutrition. After the intervention, the proportion of children who had regular health check‐ups, who were vaccinated and who met the minimum YYB consumption significantly increased from 26.0%, 81.6%, and 67.8% to 59.7%, 95.0%, and 79.2%. Increased rates of IYCF indicators (introduction of solid, semisolid, or soft foods, minimum dietary diversity and consumption of iron‐rich or iron‐fortified foods) were observed after the intervention. The prevalence of stunting, underweight, wasting, and anaemia significantly decreased from 26.3% to 10.8%, 13.4% to 8.7%, 14.0% to 10.5%, and 52.1% to 43.9%. This intervention can be well integrated into the YYB programme with less additional resources. Children in resource‐limited areas will benefit more from a comprehensive nutritional package, including food supplements and child health education. Key messages: Current evidence suggests there is a decrease in the prevalence of undernutrition among children under 5 years of age in China during recent decades. However, imbalanced development exists between rural and urban areas.Government‐funded Ying Yang Bao (YYB) programme has been implemented in poor rural areas across China covering over 800 counties, to decrease the risk of developing anaemia among children aged 6–23 months.After a child health counselling intervention jointly implemented with YYB programme, the prevalence of stunting, underweight, wasting, and anaemia among children decreased significantly.Child health counselling intervention could be well integrated into the ongoing YYB programme to reach resource‐limited areas on a large scale. [ABSTRACT FROM AUTHOR]

We aimed to describe the co‐occurrence of known risk factors for undernutrition and the prevalence of modifiable risks in wasted, stunted and healthy children. Quota sampling was used to recruit healthy [weight for age Z scores (WAZ) > −2 SD] and undernourished [weight for length (WLZ) or WAZ scores ≤ −2 SD] children aged 6–24 months from seven clinics in low‐income areas of Nairobi. Structured interviews were used to identify exposure to socioeconomic, water and hygiene, infant feeding, dietary and behavioural risks (low interest in food, high food refusal and force feeding). We recruited 92 wasted WLZ ≤ −2 SD, 133 stunted (length for age Z scores LAZ ≤ −2 SD) and 172 healthy (LAZ and WLZ > 2SD) children. Nearly all children were exposed to hygiene risks (90%) and low dietary diversity (95%) regardless of nutritional status. Stunted children were more likely to be exposed to socio‐economic risks (54% healthy, 64% wasted and 72% stunted; P = 0.001). Compared with healthy children, wasted and stunted children were more likely to be exposed to infant feeding (25% healthy, 40% wasted and 41% stunted; P = 0.02) and behaviour risks (24% healthy, 49% wasted, and 44% stunted; P = 0.004). Overall, wasted and stunted children were twice as likely to be exposed to more than three risks (23% healthy, 48% wasted, and 50% stunted; P = <0.001). They were also more likely to be exposed to more than three modifiable risks (dietary, handwashing and behaviour risks). Wasting and stunting are associated with exposure to multiple risk factors, many of which are potentially modifiable using targeted advice. [ABSTRACT FROM AUTHOR]

This systematic review and meta‐analysis aimed to assess the robustness of designs and tools used in nutrition social behaviour change communication (NSBCC) interventions and establish their effectiveness. EBSCOhost as an umbrella database including Medline (Ovid) and CINAHL, EMBASE, and ProQUEST databases were searched for peer‐reviewed articles from January 1960 to October 2018. Additional sources were searched to identify all relevant studies including grey literature. Studies' biases were assessed according to Cochrane handbook. Pooled estimate of effectiveness of interventions on infant and young child feeding (IYCF) practices and child nutritional status with 95% confidence intervals were measured using random‐effects models. Eighty studies were included in this review: Fifty‐one (64%) were cluster randomised controlled trials (RCTs), 13 (16%) were RCTs and 16 (20%) quasi‐experimental. Of the included studies, 22 (27%) measured early initiation of breastfeeding, 38 (47%) measured exclusive breastfeeding, 29 (36%) measured minimum dietary diversity, 21 (26%) measured minimum meal frequency, 26 (32%) measured height for age z‐scores (HAZ), 23 (29%) measured weight for height z‐scores (WHZ), 27 (34%) measured weight for age z‐scores (WAZ), 20 (25%) measured stunting, 14 (17%) measured wasting, and 11 (14%) measured underweight. The overall intervention's effect was significant for exclusive breastfeeding (EBF) (odds ratio = 1.73; 95% confidence interval [CI]: 1.35–2.11, p < 0.001), HAZ (standardized mean differences [SMD] = 0.19; 95% CI: 0.17–0.21; p < 0.001), WHZ (SMD = 0.02; 95% CI: 0.004–0.04; p < 0.001), and WAZ (SMD = 0.04; 95% CI: 0.02–0.06; p < 0.001). Evidence shows the effectiveness of NSBCC in improving EBF and child anthropometric outcomes. Further research should test the impact on child nutritional status with clearly specified and detailed NSBCC interventions. Key messages: Some nutrition social behaviour change communication (NSBCC) interventions significantly improved exclusive breastfeeding (EBF) practices and child anthropometric outcomes and need to be considered while planning child nutrition interventions.Studies used different intervention protocols and operational definitions. Most studies employed a mix of the NSBCC interventions often with unspecified frequency and dosage.Future intervention studies should provide detailed implementation strategies for NSBCC interventions and use standard indicators to measure child nutritional status outcome indicators. [ABSTRACT FROM AUTHOR]

In 2014, the Emergency Nutrition Network published a report on the relationship between wasting and stunting. We aim to review evidence generated since that review to better understand the implications for improving child nutrition, health and survival. We conducted a systematic review following PRISMA guidelines, registered with PROSPERO. We identified search terms that describe wasting and stunting and the relationship between the two. We included studies related to children under five from low‐ and middle‐income countries that assessed both ponderal growth/wasting and linear growth/stunting and the association between the two. We included 45 studies. The review found the peak incidence of both wasting and stunting is between birth and 3 months. There is a strong association between the two conditions whereby episodes of wasting contribute to stunting and, to a lesser extent, stunting leads to wasting. Children with multiple anthropometric deficits, including concurrent stunting and wasting, have the highest risk of near‐term mortality when compared with children with any one deficit alone. Furthermore, evidence suggests that the use of mid‐upper‐arm circumference combined with weight‐for‐age Z score might effectively identify children at most risk of near‐term mortality. Wasting and stunting, driven by common factors, frequently occur in the same child, either simultaneously or at different moments through their life course. Evidence of a process of accumulation of nutritional deficits and increased risk of mortality over a child's life demonstrates the pressing need for integrated policy, financing and programmatic approaches to the prevention and treatment of child malnutrition. [ABSTRACT FROM AUTHOR]

Despite the high prevalence of inadequate gestational weight gain (GWG) and adverse pregnancy outcomes, very few studies have addressed the association between GWG and pregnancy outcomes in South Asia. Our objectives were to estimate the prevalence of GWG during the second and third trimesters within, below and above the Institute of Medicine (IOM) guidelines, and to estimate the effect of the rate and adequacy of GWG on gestational age at the time of delivery, weight, length, length‐for‐age z‐score (LAZ), weight‐for‐length z‐score (WLZ) and adverse pregnancy outcomes, namely prematurity, small‐for‐gestational age (SGA), low birth weight (LBW), stunting and wasting at birth. We analysed data from the intervention group of the Women and Infants Integrated Interventions for Growth Study (WINGS), which is an ongoing individually randomized factorial design study. Of the 1332 women analysed, 40.2% [95% confidence interval (CI) 37.5 to 42.8] had GWG below the IOM guidelines. For every 100‐g/week increase in GWG, birth weight increased by 61 g, birth length by 0.16 cm, LAZ score by 0.08 SD, WLZ score by 0.14 SD, and gestational age at birth by 0.48 days. Women with GWG below the IOM guidelines had a higher relative risk of adverse pregnancy outcomes (44% for LBW, 27% for SGA, 32% for stunting and 42% for wasting at birth) than women who had GWG within the IOM guidelines, except for prematurity. The association between GWG and LAZ scores at birth was modified by early pregnancy body mass index (BMI). GWG is a strong predictor of newborn anthropometric outcomes and duration of gestation but not prematurity. [ABSTRACT FROM AUTHOR]

This study aimed to present an overview of the association between dietary diversity (DDiv) and growth outcomes (stunting, wasting, and underweight) in children aged < 5 years. This systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. PubMed, Scopus, Embase, Cochrane library, and Google Scholar databases were searched up to February, 2021, using relevant keywords as follows: "Dietary diversity or diet diversity or food diversity or diet variety or dietary variety or food variety," "under-nutrition or stunting or wasting or underweight or nutritional status," and "children or infants." Original articles published in English were eligible for this review. Newcastle-Ottawa scales and the Cochrane Collaboration's tool were used to assess the quality and risk of bias of the articles. Totally, 81 articles (70 cross-sectional, 4 longitudinal cohort, 5 case-control, and 2 randomized controlled trials) were included in this review. Of the studies, 45 focused on infants and 36 on children aged < 5 years. The reviewed articles had good quality and low risk of bias (scores > 6). In infants, low DDiv was associated with stunting, wasting, and being underweight (79%, 57%, and 68% of the studies, respectively). Among children aged < 5 years, the association was observed in 75%, 56%, and 57% of the studies, respectively, for stunting, wasting, and underweight. The findings indicate a possible association between low DDiv of infants and children aged < 5 years with stunting. However, this association remained uncertain with wasting and being underweight. [ABSTRACT FROM AUTHOR]

Background: Adequate nutrition during childhood is essential to promote child growth and development. Objective: The study evaluated the relationship of habitual nutrient intake and protein adequacy to the prevalence of child malnutrition. Methods: Data were derived from a nationally representative sample of children aged 6-12 years. Two nonconsecutive day 24-h dietary recalls (24hR) were collected to estimate the individual food intake. PC-SIDE version 1.0 software (Software for Intake Distribution Estimation) was used to estimate the habitual intake of key nutrients accounting for between- and within-person differences in dietary intake. The 2007 WHO Protein Digestibility Corrected Amino Acid Score (PDCAAS) method was used to measure the protein quality or the utilizable protein intake. The nutritional status of the participants is reflected in the weight-for-age, height-for-age, and body mass index (BMI)-for-age z-scores using the WHO Growth Reference Standard (WHO, 2007). Results: Undernourished school-aged children were found to have high protein inadequacy. Higher consumption of grains and cereal products, meat, and high-quality protein foods was associated with a lower risk of stunting. Higher intake of milk and milk products, grains and cereal products, high-quality protein foods, calcium, riboflavin, and vitamin C was associated with a lower risk of underweight. Higher consumption of grains and cereal products, riboflavin, thiamine, and fiber was associated with a lower risk of wasting. On the contrary, higher consumption of meat, milk and milk products, grains and cereal products, high-quality protein foods, and vitamin C was associated with a higher risk of obesity. Furthermore, linear growth of children was found to be associated with high-quality protein foods, calcium, vitamin B12, vitamin C, and vitamin D. Conclusions: Malnutrition among Filipino children is influenced by nutrient intakes. However, the existence of malnutrition among children may be specifically attributed to the quality of protein consumed. Therefore, the study suggests that nutrition interventions and policies focusing on child malnutrition should improve not just the quantity but also the quality of protein sources consumed by children to aid in proper growth and development. [ABSTRACT FROM AUTHOR]

Introduction: Protists of the genus Labyrinthula cause the so-called “Wasting Disease” in seagrass, Thalassia testudinum. Monitoring in the Colombian Caribbean since 2008 has shown spatial and temporal variation in the disease’s incidence, but without the high mortality observed in other regions of the world. Objective: To analyze some epidemiological parameters in T. testudinum and to compare metabolites between healthy and infected plants. Methods: We recorded severity, incidence and prevalence of this disease in Tayrona National Natural Park and Providencia Island, and we analyze water and sediment samples. Additionally, we applied gas and liquid chromatography, coupled with mass spectrometry, to methanolic extracts from leaf and rhizome samples of healthy and infected shoots. Results: The meadows were in good condition, despite the scarce seagrass shoots in Tayrona and a high incidence (15 %) and severity (35.5 %) of the disease in Providencia. Infected plants had lower levels of phenols, flavonoids and sugars. Sulphated flavones with aglycone luteolin and diosmetin, sterols (sitosterol and stigmasterol) and volatile oxylipins are accumulated in leaves (3-hydroxy-2-isopentanone) and isopentaenoic and octadecatrienoic acids in rhizomes. Conclusions: These Colombian seagrasses have differential production of metabolites. Probably as a successful defense, even at low levels of severity (0.1 %) and incidence (1 %) of the disease. [ABSTRACT FROM AUTHOR]

Children with chronic kidney disease (CKD) are vulnerable to undernutrition and its accompanying consequences. Assessment of nutrition in these children is confounded by the presence of edema and overhydration. There is no single measure that can comprehensively reflect the underlying nutrition status. Hence, there is a need to explore nutrition assessment tools that reflect body composition without being affected by hydration status. Many tools of assessment that are widely studied in adults with CKD get extrapolated to children. Studies on nutritional assessment focusing on pediatric patients with CKD are needed for early recognition and long-term monitoring of nutrition status. This review attempts to provide an understanding of the utility and limitations of tools available for assessment of nutrition and body composition in the context of undernutrition in pediatric CKD. [ABSTRACT FROM AUTHOR]

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Background: Malnutrition among under-five children is a foremost public health problem across India. United Nation estimates that 6.3 million under the age of five die in India, of which 45% die due to malnutrition. The objective of the study was to find out the prevalence and factors associated with malnutrition in terms of underweight, stunting, and wasting in children under five years of age in peri-tribal areas. Methods: Cross sectional study was conducted at the Anganwadi centres in 6 villages under the Rural Health Training Centre. Out of nine Anganwadi centres, five were selected using systematic random sampling method. Total of 370 children aged below five years were selected. Results: Among the 370 children aged 0-5 years, 29.1% children were normally nourished, 70.79% children were malnourished and had one or more form of malnutrition. Only stunting was present in 19.5% children and only wasting was present in 8.9% children. Both underweight and stunting were seen in 5.94% children. Both stunting and wasting were present in 22.16% children and wasting and underweight were present in 10.5% children. respectively, 1% Children were suffering from underweight, stunting and wasting. All three indices (Underweight, Stunting & Wasting) of under nutrition were found to be higher in low-birth-weight children. Conclusion: Mother's educational qualification is strongly associated with nutritional status of children. This might be due to better health care practices in terms of proper exclusive breast feeding, in-time complementary feeding and quality and quantity of complementary feeding among literate mothers as compared to illiterate mothers. [ABSTRACT FROM AUTHOR]

Minimally invasive tissue sampling (MITS) is increasingly being used to better understand causes of death in low-resource settings. Undernutrition (eg, wasting, stunting) is prevalent among children globally and yet not consistently coded or uniformly included on death certificates in MITS studies when present. Consistent and accurate attribution of undernutrition is fundamental to understanding its contribution to child deaths. In May 2020, members of the MITS Alliance Cause of Death Technical Working Group convened a panel of experts in public health, child health, nutrition, infectious diseases, and MITS to develop guidance for systematic integration of undernutrition, as assessed by anthropometry, in cause of death coding, including as part of the causal chain or as a contributing condition, in children <5 years of age. The guidance presented here will support MITS and other researchers, public health practitioners, and clinicians with a systematic approach to assigning and interpreting undernutrition in death certification. [ABSTRACT FROM AUTHOR]

Cachexia is a muscle wasting syndrome occurring in many advanced cancer patients. Cachexia significantly increases cancer morbidity and mortality. Cardiac atrophy and contractility deficits have been observed in patients and in animal models with cancer cachexia, which may contribute to cachexia pathophysiology. However, underlying contributors to decreased in vivo cardiac contractility are not well understood. In this study, we sought to distinguish heart-intrinsic changes from systemic factors contributing to cachexia-associated cardiac dysfunction. We hypothesized that isolated heart and cardiac myocyte functional deficits underlie in vivo contractile dysfunction. To test this hypothesis, isolated heart and cardiac myocyte function was measured in the colon-26 adenocarcinoma murine model of cachexia. Ex vivo perfused hearts from cachectic animals exhibited marked contraction and relaxation deficits during basal and pacing conditions. Isolated myocytes displayed significantly decreased peak contraction and relaxation rates, which was accompanied by decreased peak calcium and decay rates. This study uncovers significant organ and cellular-level functional deficits in cachectic hearts outside of the catabolic in vivo environment, which is explained in part by impaired calcium cycling. These data provide insight into physiological mechanisms of cardiomyopathy in cachexia, which is critical for the ultimate development of effective treatments for patients. [ABSTRACT FROM AUTHOR]

Until recently, the sunflower star, Pycnopodia helianthoides , was a dominant and common predator in a wide variety of benthic habitats in the northeast Pacific. Then, in 2013, its populations began to plummet across its entire range as a result of the spread of a phenomenon known as sea star wasting disease, or sea star wasting. Although dozens of sea star species were impacted by this wasting event, P. helianthoides seems to have suffered the greatest losses and is now listed by the International Union for the Conservation of Nature as the first critically endangered sea star. In order to learn more about the life history of this endangered predator and to explore the potential for its restoration, we have initiated a captive rearing program to attempt complete life-cycle (egg-to-egg) culture for P. helianthoides. We report our observations on holding and distinguishing individual adults, reproductive seasonality, larval development, inducers of settlement, and early juvenile growth and feeding. These efforts will promote and help guide conservation interventions to protect remaining populations of this species in the wild and facilitate its ultimate return. [ABSTRACT FROM AUTHOR]

Background: Water and electrolyte disorders commonly encountered in children post-surgery involving hypothalamus and posterior pituitary, are central diabetes insipidus, syndrome of inappropriate secretion of anti-diuretic hormone and cerebral salt wasting disease. Delayed diagnosis and inadequate management of such cases may lead to worsened neurological outcomes with a high mortality rate.Case Presentation: Here we report the case of a 7-year-old girl who underwent surgical resection of a craniopharyngioma, following which she initially developed central diabetes insipidus. However, later on in the course of her illness she developed symptomatic hyponatremia with natriuresis which was diagnosed to be due to cerebral salt wasting disease. This combination of central diabetes insipidus and cerebral salt wasting syndrome is a rare occurrence and poses a diagnostic challenge. Diagnosis and management can be even more difficult when these conditions precede or coexist with each other.Conclusion: In such cases development of hyponatremia should always prompt consideration of unusual causes like cerebral salt wasting disease in addition to the classically described syndrome of inappropriate secretion of anti-diuretic hormone. Hence, a thorough knowledge of these disorders along with intensive monitoring of fluid and sodium status is critical for timely diagnosis and management of these patients. [ABSTRACT FROM AUTHOR]

Porcine circovirus type 2 (PCV2) is the etiological agent of post-weaning multisystemic wasting syndrome (PMWS). The original prevalent genotype, PCV2a, has been replaced by genotypes 2b and 2d in the swine population worldwide. The Rep protein is critical for viral replication. Comparison of a large number of Rep protein amino acid (aa) sequences showed that three sites distinguish genotype 2b from genotype 2d. In order to analyze the effect of exchanging the amino acids (asparagine and serine) at position 6 in the Rep proteins of PCV2b and PCV2d, two wild-type and two mutant viruses were rescued. Real-time quantitative PCR and a one-step growth curve were used to determine the viral load to assess the replication ability of the rescued viruses. The results showed that there was no significant difference in in vitro performance between the wild-type PCV2b and the mutated virus, while the mutation of PCV2d enhanced viral replication. [ABSTRACT FROM AUTHOR]

Background: Recent studies suggest potential benefits of applying L-carnitine in the treatment of cancer cachexia, but the precise mechanisms underlying these benefits remain unknown. This study was conducted to determine the mechanism by which L-carnitine reduces cancer cachexia. Methods: C2C12 cells were differentiated into myotubes by growing them in DMEM for 24 h (hrs) and then changing the media to DMEM supplemented with 2% horse serum. Differentiated myotubes were treated for 2 h with TNF-α to establish a muscle atrophy cell model. After treated with L-carnitine, protein expression of MuRF1, MaFbx, FOXO3, p-FOXO3a, Akt, p-Akt, p70S6K and p-p70S6K was determined by Western blotting. Then siRNA-Akt was used to determine that L-carnitine ameliorated cancer cachexia via the Akt/FOXO3/MaFbx. In vivo, the cancer cachexia model was established by subcutaneously transplanting CT26 cells into the left flanks of the BALB/c nude mice. After treated with L-carnitine, serum levels of IL-1, IL-6 and TNF-α, and the skeletal muscle content of MuRF1, MaFbx, FOXO3, p-FOXO3a, Akt, p-Akt, p70S6K and p-p70S6K were measured. Results: L-carnitine increased the gastrocnemius muscle (GM) weight in the CT26-bearing cachexia mouse model and the cross-sectional fiber area of the GM and myotube diameters of C2C12 cells treated with TNF-α. Additionally, L-carnitine reduced the protein expression of MuRF1, MaFbx and FOXO3a, and increased the p-FOXO3a level in vivo and in vitro. Inhibition of Akt, upstream of FOXO3a, reversed the effects of L-carnitine on the FOXO3a/MaFbx pathway and myotube diameters, without affecting FOXO3a/MuRF-1. In addition to regulating the ubiquitination of muscle proteins, L-carnitine also increased the levels of p-p70S6K and p70S6K, which are involved in protein synthesis. Akt inhibition did not reverse the effects of L-carnitine on p70S6K and p-p70S6K. Hence, L-carnitine ameliorated cancer cachexia via the Akt/FOXO3/MaFbx and p70S6K pathways. Moreover, L-carnitine reduced the serum levels of IL-1 and IL-6, factors known to induce cancer cachexia. However, there were minimal effects on TNF-α, another inducer of cachexia, in the in vivo model. Conclusion: These results revealed a novel mechanism by which L-carnitine protects muscle cells and reduces inflammation related to cancer cachexia. [ABSTRACT FROM AUTHOR]

Cancer cachexia, often referred to as "wasting syndrome," is characterized by fatigue, weakness, and involuntary weight loss. This syndrome is concomitant with progressive skeletal muscle atrophy with or without adipose tissue loss and is frequently accompanied by systemic inflammation. Understanding the complexities of cancer cachexia is crucial for early detection and intervention, and it is also paramount for enhancing patient outcomes. Medical imaging, comprising diverse imaging modalities, plays a pivotal role in this context, facilitating the diagnosis and surveillance assessment of both the disease extent and the body composition changes that offer valuable information and insights into disease progression. This article provides a comprehensive discourse of the pathophysiological mechanisms and clinical manifestations of cancer cachexia as well as the role of medical imaging in this setting. Particular emphasis is placed on contemporary multidisciplinary and translational research efforts for the development of diagnostic and treatment tools, aiming to mitigate the devastating consequences of cancer cachexia., (© 2024. The Author(s).)

Background: Vitamin D deficiency and/or insufficiency (hypovitaminosis D) has been associated with several disorders including autoimmune diseases, like type 1 diabetes mellitus; cardiovascular diseases; neoplasms; obesity; insulin resistance, and type 2 diabetes mellitus. This problem is common in southern European countries, especially in elderly and institutionalized persons. In HIV-infected individuals, hypovitaminosis D has been correlated with various complications like tuberculosis, hyperparathyroidism, bone mass loss, premature atherosclerosis, and systemic arterial hypertension, deterioration of immune function, progression of the disease and overall mortality., Objective: The objective of this study was to examine the prevalence and causes of hypovitaminosis D in a cohort of Greek HIV-infected patients, the factors, and possible complications associated with it., Methods: All patients attending our HIV unit for a period of 5 months were included in this study. Vitamin D status, medical anamnes, and laboratory tests were obtained at baseline; patients were followed for 3 years and HIV-related complications were noted. No patient received vitamin D supplementation during the follow-up period., Results: Hypovitaminosis D was common, with 83.7% of the patients showing levels below 30ng/dl and 55.4% below 20ng/dl. After multivariable analysis, age and duration of treatment were the only significant factors for low vitamin D levels. During follow-up, 26 patients exhibited a total of 34 HIV-related complications, the most common being pneumonocystis jiroveci pneumonia (PCP). Hypovitaminosis D showed a positive correlation with overall complications, PCP as well as wasting syndrome., Conclusion: Overall, our study shows that hypovitaminosis D is common in HIV-infected individuals and should probably be treated as soon as possible to protect these patients from serious HIVrelated complications like PCP or wasting syndrome., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background. Following acute traumatic brain injury, cerebral salt wasting (CSW) syndrome is considered as an important cause of hyponatremia apart from syndrome of inappropriate antidiuretic hormone. Differentiation between the two syndromes is crucial for the initiation of an adequate treatment. Case Presentation. We report a 15-year-old female adolescent, admitted to intensive care for acute severe traumatic brain injury. During his hospitalization, she developed a hyponatremia with an increase of urine output and hypovolemia. So, the most probable diagnosis was CSW. Initially, she was treated by hypertonic saline and volume expansion. However, his sodium level continued to fall despite infusion of hypertonic saline. That is why fludrocortisone was introduced initially at 50 μg/day then increased to 150 μg/day. Fludrocortisone was continued for the next months. Serum sodium level was 138 mmol/L after one month of treatment. Conclusion. Hyponatremia may occur after severe traumatic brain injury that is why an adequate treatment initiated on time is necessary in order to reduce morbidity and mortality. [ABSTRACT FROM AUTHOR]

A key to enhance the low translatability of preclinical drug discovery are in vitro human three-dimensional (3D) microphysiological systems (MPS). Here, we show a new method for automated engineering of 3D human skeletal muscle models in microplates and functional compound screening to address the lack of muscle wasting disease medication. To this end, we adapted our recently described 24-well plate 3D bioprinting platform with a printhead cooling system to allow microvalve-based drop-on-demand printing of cell-laden Matrigel containing primary human muscle precursor cells. Mini skeletal muscle models develop within a week exhibiting contractile, striated myofibers aligned between two attachment posts. As an in vitro exercise model, repeated high impact stimulation of contractions for 3 h by a custom-made electrical pulse stimulation (EPS) system for 24-well plates induced interleukin-6 myokine expression and Akt hypertrophy pathway activation. Furthermore, the known muscle stimulators caffeine and Tirasemtiv acutely increase EPS-induced contractile force of the models. This validated new human muscle MPS will benefit development of drugs against muscle wasting diseases. Moreover, our Matrigel 3D bioprinting platform will allow engineering of non-self-organizing complex human 3D MPS. Alave-Furrer et al adapted their recently-developed 3D bioprinting platform to allow microvalve-based drop-on-demand printing of cell-laden Matrigel containing primary human muscle precursor cells. Their bioprinting platform recapitulated aspects of exercise and pharmacological responses and thus could aid the engineering of more complex 3D microphysiological systems. [ABSTRACT FROM AUTHOR]

Incineration is the most used healthcare waste (HCW) disposal method. Disease outbreaks due to Ebola virus and SARS-CoV2 require attention to HCW management to avoid pathogens spread and spillover. This study describes HCW management prior to incineration and hospital incinerators performance by analysing bottom ashes from hospitals in Kinshasa, Democratic Republic of Congo. We used semi-structured interviews to capture information on pre-incineration waste management and analysed the chemical composition of 27 samples of incinerator bottom ashes using the energy dispersive X-ray fluorescence. Neither sorting nor waste management measures were applied at hospitals surveyed. Incinerator operators were poorly equipped and their knowledge was limited. The bottom ash concentrations of cadmium, chromium, nickel and lead ranged between 0.61–10.44, 40.15–737.01, 9.11–97.55 and 16.37–240.03 mg kg−1, respectively. Compared to Chinese incinerator performance, the concentrations of some elements were found to be lower than those from China. This discrepancy may be explained by the difference in the composition of HCW. The authors conclude that health care waste in Kinshasa hospitals is poorly managed, higher concentrations of heavy metals are found in incinerator bottom ashes and the incinerators quality is poor. They recommend the strict application of infection prevention control measures, the training of incinerator operators and the use of high-performance incinerators. [ABSTRACT FROM AUTHOR]