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A 7-year-old boy presented with diffuse bone pain. FDG PET/CT was performed to find the possible underlying malignant cause of hypercalcemia. The images demonstrated multiple foci of abnormal FDG activity at the sites of periosteal reaction. In addition, calcium deposit was noted in the basal ganglia, stomach, and the colon. History taking revealed that the patient had routinely taken an over-the-counter "supplement" that contains a high dose of vitamin D. One week after calcitonin therapy and stopping the supplement, the patient became symptom free. This case suggests that hypervitaminosis D might cause hypermetabolic periosteal reaction on FDG PET/CT imaging.

Vitamins and minerals have essential functions in the body, from signal transduction to acting as cofactors for numerous enzymatic processes. Nutritional deficiencies and excess of certain vitamins and minerals can have profound effects on the central and peripheral nervous systems from early development into adulthood. This article summarizes the role of various nutritional factors in the nervous system and the neurological symptoms that can arise from deficiency or excess., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Body composition (BC) assessment is indispensable to evaluate nutritional status and thus health, both at the population and individual level, and to assess the efficacy of primary and secondary preventive nutritional strategies. Changes in BC, including the regional distribution of body fat, largely occur during pubertal transition, with marked differences between genders. They may, however, also occur in the elderly, who experience significant changes in the ratio between body fat and muscle with aging. The development and implementation of more sophisticated techniques (e.g. BC assessment at the molecular and atomic levels) could provide a major contribution to determining BC at different levels. This review discusses the application of dual-energy X-ray absorptiometry (DXA) on BC determination, given that DXA has the potential to provide overall and regional assessment of BC in terms of fat, lean mass and bone. DXA is widely used in many clinical settings primarily diagnosis osteoporosis. This article describes the use of whole-body DXA in assessing BC in patients with chronic diseases (e.g. metabolic syndrome) as well as in different sport activities to evaluate the effects of exercise.

This case report describes the management of a chronically malnourished woman during her first and second pregnancies. The emphasis of the management is on the investigation of her dysphagia and subsequent bypassing of her colonic interposition by the formation of a percutaneous gastrostomy. The case highlights spontaneous conception with a body mass index of 14 and the safety of enteral feeding during pregnancy.

Objectives: Denutrition is a frequent condition in elderly persons and may have major consequences. A noninvasive investigation, whole body dual energy X-ray absorptiometry, should allow, by direct measurement of body composition, early and reliable diagnosis of denutrition. This study was conducted to elaborate a diagnostic tool using this exam and to test its validity., Patients and Methods: A global index of denutrition was proposed combining anthropometric, biological criteria, and the Mini Nutritional Assessment scale. Two agreement analyses were made between classical diagnostic criteria of nutritional status and body fat and fat free mass assessed by anthropometry and absorptiometry. An association between nutritional status and body absorptiometric composition were studied with univariate analysis followed by a multivariate logistic regression model. This model allowed an elaboration of a nutritional absorptiometric index (NAI)., Results: One hundred one elderly subjects were included. Twenty-three were considered to be in a state of denutrition. Agreement was poor between anthropometric and biological diagnostic criteria of denutrition. It was good between the different masses assess by anthropometry and absorptiometry. Subjects in a state of denutrition had significantly lower body fat and lower fat free mass. The fat free mass index (fat free mass divided by the square height) and body fat were entered into a logistic model and composed the NAI, which showed good diagnostic validity in terms of specificity and sensitivity., Discussion: Absorptiometry appears to be a simple reliable diagnostic tool for assessing denutrition in elderly persons in routine practice. Further studies are required and should lead to a confirmation of the interest of these absorptiometric indexes.

Malnutrition, shown by fat depletion and muscle wasting, is common in uremia. The methods used to describe body composition in uremia are controversial. We have used ultrasonography of the thigh to evaluate fat and muscle in haemodialysis patients (group 1) (n = 14), peritoneal dialysis patients (group 2) (n = 10) and normal controls (group 3) (n = 13). Musculus rectus femoris diameter (0.84 +/- 0.06 cm versus 1.15 +/- 0.08 cm, p < 0.05) and cross sectional area (3.0 +/- 0.4 cm2 versus 5.5 +/- 0.4 cm2, p < 0.01) were significantly reduced in group 1 compared with group 3, as was also muscle area in group 2 (3.9 +/- 0.6, p < 0.05), indicating malnutrition in the dialysis patients. Peritoneal dialysis patients tended to have more subcutaneous fat (p = 0.07) and a larger musculus rectus diameter (p = 0.09) than haemodialysis patients, possibly reflecting better preserved nutritional status. Ultrasonography was equal to computed tomography for estimating these parameters. Ultrasonography is a useful tool for evaluating body composition in uremia, and has a capacity for detection of malnutrition, and possibly for early discrimination between patient groups with different dialysis modalities.

Ultrasonographic, blinded assessment was made of the extent of hepatic steatosis in 55 children with severe malnutrition: undernutrition (n = 6), marasmus (n = 18), marasmickwashiorkor (n = 17), and kwashiorkor (n = 14). The children were examined on admission, in early recovery (considered as baseline), and again at discharge. Eleven healthy control children and eight of the previously malnourished children were studied as comparison groups. Both oedematous and non-oedematous malnourished children had significantly more steatosis than the comparison groups at each time. Children with oedematous malnutrition had significantly greater steatosis than non-oedematous children at admission. Half of the non-oedematous malnourished children had appreciable hepatic steatosis at both admission and at baseline. Hepatic fat was only slowly mobilised. The rate constant was 1.4 +/- 0.3%/day. One quarter of the children did not change steatosis grades during the period they were in hospital. There was no overall correlation between the extent of steatosis and liver size. Hepatic steatosis in childhood malnutrition is not confined to oedematous children: it is frequently present in marasmic and undernourished children. Its extent is not necessarily related to the degree of hepatomegaly and accumulated lipid is only slowly mobilised.

This study was undertaken to investigate pancreatic changes associated with phasic insulin dependent diabetes mellitus (PIDDM). Twelve PIDDM patients were studied. They were compared with groups of patients, 10 insulin dependent (IDDM), 10 non-insulin dependent (NIDDM), and 10 normal controls. Each group was matched for age, sex, and body mass index. For the study, the mean age was 56.7 +/- 2.5 years, mean body mass index 24.0 +/- 0.8, and mean duration of diabetes 14.2 +/- 2.2 years. Flat abdominal radiograph and ultrasonography were performed on each participant. The results suggest an increased echogenicity of the pancreas in the phasic insulin dependent group of patients.

Trabeculae represent the smallest functional component of bone visible with conventional radiographic methods. Their architecture is affected by mechanical, hormonal, nutritional, genetic, toxic, and local disease processes. Trabecular evaluation, if coupled with a knowledge of normal trabecular development in children, can represent a sensitive index of bone malfunction, at least as judged radiographically. This paper explores alterations in the trabecular architecture of the upper end of the femur in children.

Skeletal changes in deficient or badly balanced nutrition (alimentary osteopathies) and osseous changes accompanying chronic disease of internal organs and metabolic disorders (metabolic osteopathies) are discussed. Basically, the classical generalised skeletal changes such as osteoporosis, osteomalacia, fibroosteoclacia and sclerosis of the bone can occur in their pure form or as a combination of two ore more of these disorders. Finally the exogenic toxic osteopathies are discussed, nowadays fluorosis being the most important. Other external factors may be drugs such as methotrexate and antiepileptic medications.

One of the prime nutritional concerns in cancer patients is cachexia and deteriorating nutritional status. Cachexia can occur as a result of either treatment or the tumor itself. The progressive malnutrition ultimately affects performance status and organ function. Tolerance to treatment may thus be decreased, which, in turn, may adversely affect toxicity and response. In addition, the deleterious effects of malnutrition on the immune system can increase susceptibility to infection. The weakness and fatigue related to muscle wasting and changes in metabolism affect physical appearance, leading to a loss of self-esteem. Thus, the vicious cycle of cachexia severely impacts on every aspect of daily life. Providing nutritional support and effective treatment may reverse the cachexia. Studies involving caloric supplements alone have not been encouraging. Conversely, studies using megestrol acetate have shown that cancer patients gain weight and that their sense of well-being improves. However, the mechanisms of weight gain remain unknown, and further studies are needed to determine the mechanisms by which appetite is stimulated or catabolism is inhibited or both. Nursing interventions to stimulate appetite and promote greater food intake, coupled with the use of agents that alter metabolism, such as megestrol acetate, may reverse the trend of cachexia and thus provide an increased sense of well-being and improved quality of life.

Radiological assessment of arm fat and muscle stores was performed in 46 controls and 10 malnourished patients. Values for arm fat and muscle thickness were obtained. In malnourished patients there was no significant correlation between fat estimation from the radiograph and measurement with skinfold calipers. Significant correlation between arm muscle circumference measurement and radiological muscle thickness however was found (P less than 0.05). Radiological assessment of arm muscle is a simple and useful test of muscle protein depletion in malnourished patients.