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Type 2 diabetes mellitus (T2DM) has become a global epidemic. To effectively control T2DM, individuals must adhere to a high-quality diet that encompasses not only healthy dietary patterns but also promotes positive eating behaviors. We conducted a cross-sectional study on 314 patients with T2DM, and we evaluated the diet quality and also examined the associations between eating behavior, diet quality, and anthropometric and clinical factors in T2DM patients. We used the Diet Quality Index-International and Dutch Eating Behavior Questionnaire to assess dietary characteristics. We found that women had a significantly higher diet quality than men (61.40 vs. 58.68, p = 0.002) but were also more prone to emotional eating (2.00 vs. 1.53, p < 0.001) and restrained eating (2.39 vs. 2.05, p = 0.002). Restrained eating correlated with duration of diabetes (r = −0.169, p = 0.003), body mass index (r = 0.182, p = 0.001), and external eating with glycated hemoglobin (r = 0.114, p = 0.044). Patients with emotional eating had a higher vitamin C adequacy score (β = 0.117, p = 0.045). External eating was positively associated with grain adequacy (β = 0.208, p < 0.001) and negatively associated with empty-calorie food moderation score (β = −0.125, p = 0.032). For restrained eating, we found associations with vitamin C adequacy (β = −0.138, p = 0.017) and fruit adequacy (β = 0.125, p = 0.033). In conclusion, the results of this study provide valuable insight into dietary behavior and emphasize the importance of promoting healthy eating habits for T2DM patients. [ABSTRACT FROM AUTHOR]

Healthy dietary patterns during pregnancy are crucial for ensuring maternal and foetal health outcomes. Numerous methodologies exist for assessing the diet of pregnant women, including dietary patterns and various appraisal tools of diet quality. This study aimed to assess the dietary patterns and diet quality of pregnant women and to investigate the relationship between dietary patterns, diet quality estimators, and the adequacy of nutrient intake. EPIC FFQ was applied to a sample of 251 pregnant women, and questionnaires were interpreted with the FETA program. Dietary patterns were then determined by means of principal component analysis. Our results showed a substantial association between dietary patterns and total diet quality, as measured by the Diet Quality Index for Pregnancy (DQI-Pc), PURE Healthy Diet Score, and FIGO Diet Quality Score. We also found correlations between certain dietary patterns and particular nutrient intakes recommended by the European Food Safety Authority during pregnancy. The most deficient intake was registered for iron (86.1%), zinc (87.3%) and magnesium (79.3%), posing a threat to normal bone development, anaemia prophylaxis, and immune status. These results highlight the importance of assessing and understanding eating habits during pregnancy in order to achieve optimal outcomes for both the mother and the foetus. [ABSTRACT FROM AUTHOR]

Diet and eating behavior both play a crucial role in the prevention and management of type 2 diabetes mellitus (T2DM). The main objective of this study was to investigate the relationship between dietary intake and eating behavior in a population of patients with T2DM. A cross-sectional study was performed using 416 patients with T2DM and their dietary intake and eating behavior were assessed with validated questionnaires. Women scored significantly higher than men for emotional and restrained eating (p < 0.001). Correlation analyses showed that emotional eaters consumed significantly more calories (r = 0.120, p = 0.014) and fat (r = 0.101, p = 0.039), as well as non-alcoholic beverages for women (r = 0.193, p = 0.003) and alcohol for men (r = 0.154, p = 0.038). Also, individuals who ate based on external cues consumed significantly more calories (r = 0.188, p < 0.001) and fat (r = 0.139, p = 0.005). These results demonstrate that eating behavior influences dietary intake. Understanding this relationship could optimize diabetes management and allow for more individualized nutritional guidance. [ABSTRACT FROM AUTHOR]

The significance of dietary patterns during pregnancy is highlighted by accumulating evidence, emphasizing their pivotal role in promoting a healthy pregnancy for both the mother and the child. This study aimed to assess the current dietary patterns of pregnant women, compare the energy and nutrient intake of two distinct groups with a 10-year interval, and identify changes in dietary patterns. EPIC FFQ was applied, and its data were interpreted with the FETA program version 6 (CAMB/PQ/6/1205). By means of principal component analysis, three different food patterns were identified in each study group: vegetarian, balanced, and traditional (2013); and prudent, vegetarian, and modern (2023). Analyzing the relationship between food groups and gestational weight, we found that gestational weight gain in 2013 was positively correlated with eggs and egg dishes and milk and milk products, whereas in 2023, gestational weight gain was positively correlated with fats and oils, non-alcoholic beverages, and the modern pattern. Additionally, in 2023, pre-gestational BMI correlated positively with eggs and egg dishes. The balanced pattern emerged as a predictor for a lower likelihood of inadequate gestational weight gain in both groups. Furthermore, normal and overweight pregnant women showed a reduced likelihood of excessive gestational weight gain. [ABSTRACT FROM AUTHOR]

Obesity affects more than one billion people worldwide and often leads to cardiometabolic chronic comorbidities. It induces senescence-related alterations in adipose tissue, and senescence is closely linked to obesity. Fully elucidating the pathways through which vitamin D exerts anti-inflammatory effects may improve our understanding of local adipose tissue inflammation and the pathogenesis of metabolic disorders. In this narrative review, we compiled and analyzed the literature from diverse academic sources, focusing on recent developments to provide a comprehensive overview of the effect of vitamin D on inflammation associated with obesity and senescence. The article reveals that the activation of the NF-κB (nuclear factor kappa B subunit 1) and NLRP3 inflammasome (nucleotide-binding domain, leucine-rich-containing, pyrin domain-containing-3) pathways through the toll-like receptors, which increases oxidative stress and cytokine release, is a common mechanism underlying inflammation associated with obesity and senescence, and it discusses the potential beneficial effect of vitamin D in alleviating the development of subclinical inflammation. Investigating the main target cells and pathways of vitamin D action in adipose tissue could help uncover complex mechanisms of obesity and cellular senescence. This review summarizes significant findings related to opportunities for improving metabolic health. [ABSTRACT FROM AUTHOR]

Our paper proposes the first machine learning model to predict long-term mortality in patients with diabetic foot ulcers (DFUs). The study includes 635 patients with DFUs admitted from January 2007 to December 2017, with a follow-up period extending until December 2020. Two multilayer perceptron (MLP) classifiers were developed. The first MLP model was developed to predict whether the patient will die in the next 5 years after the current hospitalization. The second MLP classifier was built to estimate whether the patient will die in the following 10 years. The 5-year and 10-year mortality models were based on the following predictors: age; the University of Texas Staging System for Diabetic Foot Ulcers score; the Wagner–Meggitt classification; the Saint Elian Wound Score System; glomerular filtration rate; topographic aspects and the depth of the lesion; and the presence of foot ischemia, cardiovascular disease, diabetic nephropathy, and hypertension. The accuracy for the 5-year and 10-year models was 0.7717 and 0.7598, respectively (for the training set) and 0.7244 and 0.7087, respectively (for the test set). Our findings indicate that it is possible to predict with good accuracy the risk of death in patients with DFUs using non-invasive and low-cost predictors. [ABSTRACT FROM AUTHOR]

Modern lifestyles have led to sedentary behavior, lower participation in active movement and physical activities during leisure time, unhealthy diets, and increased exposure to stress. It is important to examine the interaction of several lifestyle risk factors instead of focusing on one alone. The purpose of this study was to identify lifestyle patterns in a group of patients with type 2 diabetes and the associations of its components with certain metabolic parameters. Using principal component analysis, we identified three dietary patterns: the prudent pattern (fat, oil, cereals, potatoes, vegetables, fish, nuts, seeds and fruits), the Western pattern (meat and meat products, eggs and soft drinks) and the traditional pattern (milk and its derivatives, soups and sauces, with a low intake of sugar/snacks). In addition, using the same method of analysis, we identified two lifestyle patterns: the inadequate lifestyle pattern (Western dietary pattern, increased hours of sleep and lower levels of stress) and the traditional lifestyle pattern (traditional dietary pattern, increased physical activity (PA) and non-smoking status). The inadequate lifestyle pattern was associated with younger age, hypertension and diabetic neuropathy. The traditional lifestyle pattern was related to lower postprandial blood glucose levels. Sedentary individuals were more likely to be over 65 years old and to have higher glycated hemoglobin (HbA1c). Smokers were also more likely to have inadequate glycemic and lipid profile control. [ABSTRACT FROM AUTHOR]

Diabetic foot represents the consequence of changes caused by diabetes in the foot, meaning an association of infection, ulceration and / or destruction of deep tissues with neuropathy and peripheral vascular disease in the foot, below the ankle. The aim of the study was to evaluate the factors that may influence the length of hospital stay in patients with diabetic foot ulcers. Material and methods. An observational study was performed on a sample of patients hospitalized in the Diabetes, Nutrition and Metabolic Diseases Clinic within "St. Spiridon” County Emergency Clinical Hospital, Iași, between 01.01.2007 and 31.12.2017. Sociodemographic characteristics of the patients, history of the disease, biological parameters, duration of hospitalization were registered in a database. Severity of foot ulcerations was quantified using the San Elian Wound Scoring System (SEWSS). The relationships between length of hospital stay, severity of ulceration, biological parameters and complications of diabetes were analyzed. Results. The average length of hospital stay in the studied group was 19.68 ± 13.38 days. When analyzing the correlation between length of hospital stay and inflammatory parameters, we found that it correlated positively with white blood cells, neutrophils (PMN), C-reactive protein (CRP) and negatively with hemoglobin, hematocrit, total proteins, alkaline reserve and sideremia. Assessment of the severity of ulcerations using SEWSS (mild, moderate and severe) revealed a percentage of 85.7% of cases with moderate grade ulcers, and 9% of cases having severe grade ulcers. Severity of ulcerations correlated inversely with hemoglobin, hematocrit, total proteins and sideremia. Direct correlations were found between the severity score and the following parameters: white blood cells, PMN, fibrinogen, CRP. The length of hospital stay was significantly correlated with the severity of ulceration assessed by the SEWSS (r = 0.272, p < 0.001). Conclusions. Admission in the hospital with more severe ulcerations has been associated with increased length of hospital stay, thus suggesting the need for patient education and active screening of the diabetic foot. [ABSTRACT FROM AUTHOR]

Diabetes mellitus has a major impact on metabolism, inducing many complications and contributing to increased mortality. Such complications often represent complex disorders, such as the diabetic foot, one of the major causes of non-traumatic lower limb amputation. Bone turnover and skeletal integrity can be affected in diabetes, with diabetic bone disease as a long-standing complication of it. Alveolar bone loss is one of the main features of periodontal disease, and diabetes is one of the risk factors for this condition. The present review provides complex, up-to-date information on possible common pathogenic ways related to bone turnover in these two chronic conditions, and also on the direct link between persistent hyperglycaemia, inflammation and alveolar bone loss. [ABSTRACT FROM AUTHOR]

The white adipose tissue is no longer regarded as merely a means of storing excess energy. Presently recognized for their active and dynamic secretory activity, adipocytes are capable of releasing a plethora of molecules involved in maintaining global homeostasis. Connective tissue diseases, such as systemic lupus erythematosus, idiopathic inflammatory myopathies and systemic sclerosis encompass potentially severe multi-system involvement achieved through intricate pathogenic mechanisms. Autoimmunity holds a clear and central part in the development of these conditions. Adipokines (or adipocytokines) are peptides or proteins released by the adipose tissue. Data regarding the influence of adipokines on the pathogenesis of connective tissue diseases is currently insufficient, studies often reporting discrepant results. However, the proven impact of adipokines on the modulation of inflammatory processes raises the issue of developing new therapeutic solutions with potentially beneficial effects on disease-related changes under autoimmune conditions. [ABSTRACT FROM AUTHOR]

Copyright of Internal Medicine / Medicină Internă is the property of Sciendo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Internal Medicine / Medicină Internă is the property of Sciendo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aim of this study is to assess nutritional status in a group of institutionalized elderly and to establish correlations between nutritional screening score and anthropometric parameters. We analyzed a sample of 156 seniors, 62 (39.7%) men, 94 (60.3%) women, to whom we performed nutritional screening using Mini Nutritional Assessment - MNA and we evaluated anthropometric parameters (body mass index - BMI, waist circumference - WC, calf circumference - CC and mid-upper arm circumference - MUAC). In the group of elderly institutionalized to whom the MNA has been applied, 69.2% had optimal nutritional status, 24.4% had a score of screening indicating risk of malnutrition and 6.4% had a screening score corresponding to malnutrition. A significantly higher percentage of women had a screening score indicating malnutrition (9.6% vs. 1.6%) and a screening score showing risk of malnutrition (26.6% vs. 21%) (p=0.029). Analysis by gender showed strong correlation between BMI and WC value (r = 0.869) in men, and between MUAC and CC value (r = 0.838) in women (p<0.001). Nutritional screening score was positively correlated with all anthropometric parameters (r>0.400, p<0.001), the strongest correlation being recorded with CC (r = 0.528). MNA short form (MNA-SF) represents a useful tool for rapid nutritional screening of elderly, enabling the identification of individuals at risk for malnutrition and those with a score indicating malnutrition. Calf circumference is a parameter which is positively correlated with nutritional screening score in institutionalized elderly population, and can be proposed as a starting point in nutritional assessment algorithm. [ABSTRACT FROM AUTHOR]

Connective tissue diseases (CTD) are a clinically and serologically diverse group of chronic immuno-inflammatory conditions whose complex pathomechanisms remain largely undefined. Adipokines (adipocitokines) are peptides or proteins which exhibit potential immunomodulatory properties. Recently, it has been stated that the secretory activity of white adipose tissue could play a notable role in the development or progression of certain types of disease-related organ injury in CTD, as demonstrated in both human subjects as well as animal models. In systemic lupus erythematosus, cathepsin-S and chemerin titers have been found to be higher in patients with neuropsychiartric manifestations, whereas omentin-1 levels has been found to have a lower expression in patients without kidney involvement. Moreover, the blockade of the cathepsin-S signaling pathway has been shown to associate with favorable outcomes in murine models of lupus nephritis. Research showed that patients with dermatomyositis may exhibit elevated circulating values of adiponectin and resistin, but not leptin. Additionally, visfatin gene expression was found to be higher in both adult and pediatric patients with dermatomyositis compared to healhy controls. In animal models of systemic sclerosis, adiponectin (which is thought to be a predominantly anti-inflammatory adipokine) has been associated with reduced fibrotic changes. While the results reported in the currently available literature do not imply causation, the issue of elucidating the link between adipokine expression and CTD pathogenesis remains intriguing. [ABSTRACT FROM AUTHOR]

Background This study aimed to establish the reliability and validity of the Anti-Fat Attitudes (AFA) questionnaire and the Beliefs About Obese Persons (BAOP) scale. Methodology A convenience sample of 257 students from three distinct sections of the University of Medicine and Pharmacy "Grigore T. Popa" Iasi (Medical Faculty, Nutrition and Dietetics, and Nursing) participated in an observational study. Construction validity was tested with exploratory factor analysis. The students completed a form containing sociodemographic data, the AFA questionnaire, and the BAOP scale. Weight and height were self-reported and used to determine the body mass index. Results The value of the Cronbach alpha coefficient for the AFA questionnaire indicated adequate internal consistency (0.862). The exploratory factor analysis identified the following three factors corresponding to the original questionnaire: Dislike, Fear of Fat, and Willpower. We validated a single-factor structure of the BAOP scale, which had adequate internal consistency (0.781). There were statistically significant differences (AFA: p = 0.02; BAOP: p = 0.03) between the scores of the students from Nutrition and Dietetics, Nursing, and General Medicine. Conclusions This study demonstrated that the AFA questionnaire and the BAOP scale could be used to evaluate weight stigma in healthcare students, providing a useful tool to assess the effects of weight stigma awareness interventions in this population., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. University of Medicine and Pharmacy “Grigore T. Popa” Ethics Committee issued approval 391/30.01.2024. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Mihalache et al.)

TNF inhibitors (TNFi) have revolutionized the therapeutic management of various chronic immune-mediated inflammatory diseases. Despite their known benefits, these therapies are related to paradoxical adverse effects (PAEs), including paradoxical psoriasis (PP). Although the underlying mechanism remains somewhat unclear, some theories suggest that genetic factors, particularly certain single-nucleotide polymorphisms (SNPs), may play an important role. The present review aimed to research and analyze recent findings regarding the pathomechanisms involved in the appearance of PP and the association between various genetic factors and PP in individuals treated with TNFi. We performed a literature search and found that certain genes (IL23R , TNF , FBXL19 , CTLA4 , SLC12A8 , TAP1 ) are strongly associated with the occurrence of PP in pediatric and adult patients during therapy with TNFi. The identification of the specific SNPs involved in the appearance of PP and other PAEs in patients treated with TNFi for various diseases and in different populations may later favor the recognition of those patients at a high risk of developing such adverse effects and could guide personalized therapeutic strategies in future years.

Obesity affects more than one billion people worldwide and often leads to cardiometabolic chronic comorbidities. It induces senescence-related alterations in adipose tissue, and senescence is closely linked to obesity. Fully elucidating the pathways through which vitamin D exerts anti-inflammatory effects may improve our understanding of local adipose tissue inflammation and the pathogenesis of metabolic disorders. In this narrative review, we compiled and analyzed the literature from diverse academic sources, focusing on recent developments to provide a comprehensive overview of the effect of vitamin D on inflammation associated with obesity and senescence. The article reveals that the activation of the NF-κB (nuclear factor kappa B subunit 1) and NLRP3 inflammasome (nucleotide-binding domain, leucine-rich-containing, pyrin domain-containing-3) pathways through the toll-like receptors, which increases oxidative stress and cytokine release, is a common mechanism underlying inflammation associated with obesity and senescence, and it discusses the potential beneficial effect of vitamin D in alleviating the development of subclinical inflammation. Investigating the main target cells and pathways of vitamin D action in adipose tissue could help uncover complex mechanisms of obesity and cellular senescence. This review summarizes significant findings related to opportunities for improving metabolic health.

Aim: To estimate specific nutrient intake in patients with type 2 diabetes., Materials and Methods: The study was conducted on a group of subjects with type 2 diabetes. The collected data included: anthropometry, lifestyle, blood measurements, and the mean daily nutrient intake assessed by the EPIC food frequency questionnaire., Results: The study group included 101 subjects with type 2 diabetes mellitus (DM) with a mean age of 60.6±10 years, of which 45 men (59±10.6 years) and 56 women (62±9.6 years). The average energy intake was 1714.4±713.9 Kcal/day, with a statistically significant gender difference (1877.7±850.9 kcal/day for men, 1583.1±554.9 kcal/day for women, p = 0.039, and the average daily micronutrient intake was 2.44±1.44 μg/day for vitamin D, 724.5μ263.2 mg/day for Calcium (Ca), 266.7±98 mg/day for magnesium (Mg), which was low compared to dietary recommendations. Calcium intake was correlated with intake of carbohydrates, saturated fatty acids (SFA), monounsaturated fatty acids (MUFA), fiber and energy. Vitamin D intake was correlated only with protein intake (R=0.695), while magnesium intake correlated with intake of fibers, energy, carbohydrates and SFA., Conclusions: Our study in patients with type 2 diabetes showed a reduced average intake of calcium, magnesium and vitamin D compared to standard recommendations, requiring an individualized approach.

Aim: The aim of this study was to assess the preoperative nutritional status of patients undergoing thoracic surgery using different nutritional tools., Material and Method: . We conducted a prospective study on a sample of 43 thoracic patients, including 23 with neoplasms and 20 with non-neoplastic pathology who underwent thoracic surgery procedures between July-September 2011, in the Thoracic Surgery Clinic in Iaşi. Weight and height were measured and body mass index (BMI) was calculated. WHO classification for BMI categories was used. Preoperative serum level of transthyretin (TTR) and demographic data (gender, age) were also assessed. All patients were examined by the Subjective Global Assessment (SGA) and the Nutritional Risk Screening 2002 (NRS 2002)., Results: After performing SGA, 67.9% of the patients were well-nourished, 21.4% were moderately or suspected of being malnourished and 10.7% were severely malnourished. The level of TTR was significantly lower in the moderately or severely malnourished group, compared to those considered well-nourished. According to NRS-2002, 42.9% of the patients were considered at nutritional risk. The level of TTR of these patients was lower than the level of TTR of the patients without nutritional risk, but without statistical significance., Conclusions: Subjective Global Assessment (SGA) and the Nutritional Risk Screening 2002 (NRS 2002) are useful in identifying patients with nutritional risk, so that appropriate nutritional management could be initialised even before surgery.

Aim: The aim of the study was to explore the anthropometric maternal characteristics and prenatal care as determinants of pregnancy weight gain., Material and Methods: We conducted a cross-sectional study on a total of 400 pregnant women admitted to Cuza-Vodă Obstetrics and Gynecology Clinical Hospital, Iaşi. Information on demographic characteristics, number of prenatal visits, and education on nutrition and food changes occurring during pregnancy were recorded in a structured questionnaire. Anthropometric parameters analyzed were pregestational BMI (body mass index) and weight gain during pregnancy., Results: Weight gain was associated with pregestational BMI category. An increase in weight more than recommended occured more frequently in overweight (53.1%) and obese women (66.7%) (p < 0.001). Weight gain during pregnancy was related to area of residence, age, APCU (adequate prenatal care utilization) index. The multivariate analysis identified the following variables as significant determinants of pregnancy weight gain: inadequate prenatal care, BMI and changes in diet., Conclusions: Pregestational BMI and changes in diet during pregnancy identified as determinants of weight gain suggests that overweight and underweight women must carefully be counseled regarding recommendations for weight gain in pregnancy. Tracking diet changes is important to ensure that a weight gain lies within the guidelines recommendations.

Objectives: To evaluate the rate of morbidity and mortality associated with colorectal polyps after the next 8-years period of endoscopic polypectomy, in a high risk managed care population., Material and Method: Cohorts of 77 subjects with benign neoplasms were identified with a colonoscopy in 1999. Three groups of subjects: benign neoplasms with polypectomy, benign neoplasms without polypectomy, and no neoplasms were evaluated. Five years recurrence rates (1999-2004) of benign or new malignant colorectal neoplasms were identified: for the benign determined for the baseline benign neoplasms with polypectomy and no neoplasm groups neoplasm without polypectomy, only rates for malignancy were observed. Malignancy was evaluated with immunohistochemical p53 (tumor protein 53) and PCNA (Proliferating Cell Nuclear Antigen) staining pattern. Over the next 8 years 2004-2012 were evaluated the mortality and the recurrence rate of the benign polyps., Results: 77 subjects were enrolled in our study; 71.4% were diagnosed with benign and 2.5% with malignant neoplasms. The 5-years cumulative incidence rates of malignant colorectal neoplasms in the no neoplasm (n = 20) and benign neoplasm groups (n = 55) were (n = 1) 5% and ( n = 10) 18.1%, respectively (p < 0.005). A lower 5-years malignancy rate was observed in benign neoplasms group with polypectomy (12%) compared to the benign neoplasm group without polypectomy (33.3%) (p < 0.05). The 8-years mortality rate was compared into benign recurrent polyps group and into malign group: the lower 8-years mortality rate was observed into benign polyp no neoplasm group (0%) and into benign recurrent polyps group (40%); the highest rate was observed into neoplasm group (100%)., Conclusions: The high recurrence rate of benign colorectal neoplasms and a higher incidence of colorectal cancer in subjects at high risk-history of benign colorectal neoplasm-highlight a healthcare opportunity for surveillance and/or interventions to reduce the morbidity associated with colorectal neoplasms.