Towards needed improvements in inherited metabolic medicine in adulthood: The SIMMESN adult metabolic working group and MetabERN Joint Position Statement.

Inherited metabolic disorders (IMDs), previously considered as a paediatric sub-specialisation are more and more prevalent in adults, thanks to improved survival, and the expansion of diagnostic tools detecting attenuated-late onset forms in adulthood. Italy is one of the countries with the highest number of IMDs screened by dry blood spots in neonates, allowing them to receive early treatments and to reach adult age. Despite this, awareness of IMDs is still low by the adult medical community, with difficulties in transition and transfer of patients to adult services and unmet patient needs.

Development of a questionnaire on nutritional knowledge for the obese hospitalized patient: the NUTRIKOB questionnaire.

Introduction: Different approaches, involving different areas and figures, are useful for the rehabilitation of obese subjects through a multidisciplinary hospital path. A focal point of rehabilitation is represented by education on healthy eating by increasing the dietary knowledge patients. Few tools investigating food knowledge are available in Italy: therefore, the need has emerged to develop easy-to-use tools for clinical practice that allow to detect food knowledge to set up a more targeted food re-education.

Knowledge and attitudes towards Zika virus: an Italian nation-wide cross-sectional study.

Background: Zika virus (ZIKV) is an arthropod-borne virus transmitted through infected mosquitos. The aim of this Italian nation-wide study was to evaluate general population's knowledge and attitudes towards ZIKV, its transmission, and travel-related preventive measures.

Methods: This cross-sectional study was conducted between July and August 2017, through a validated questionnaire.

The "Adipo-Cerebral" Dialogue in Childhood Obesity: Focus on Growth and Puberty. Physiopathological and Nutritional Aspects.

Overweight and obesity in children and adolescents are overwhelming problems in western countries. Adipocytes, far from being only fat deposits, are capable of endocrine functions, and the endocrine activity of adipose tissue, resumable in adipokines production, seems to be a key modulator of central nervous system function, suggesting the existence of an "adipo-cerebral axis." This connection exerts a key role in children growth and puberty development, and it is exemplified by the leptin-kisspeptin interaction.

Subcutaneous Infusion of Fluids for Hydration or Nutrition: A Review.

Subcutaneous infusion, or hypodermoclysis, is a technique whereby fluids are infused into the subcutaneous space via small-gauge needles that are typically inserted into the thighs, abdomen, back, or arms. In this review, we provide an overview of the technique, summarize findings from studies that have examined the use of subcutaneous infusion of fluids for hydration or nutrition, and describe the indications, advantages, and disadvantages of subcutaneous infusion. Taken together, the available evidence suggests that, when indicated, subcutaneous infusion can be effective for administering fluids for hydration or nutrition, with minimal complications, and has similar effectiveness and safety to the intravenous route.

Efficacy of a Disease-Specific Nutritional Support for Pressure Ulcer Healing: A Systematic Review and Meta-Analysis.

Objectives: The aim of this systematic review was to summarize the evidence on the efficacy of high-calorie, high-protein nutritional formula enriched with arginine, zinc, and antioxidants (disease-specific support) in patients with pressure ulcers (PUs).

Methods: Randomized controlled trials in English published from January 1997 until October 2015 were searched for in electronic databases (EMBASE, Medline, PubMed, and CINAHL). Studies comparing a disease-specific nutritional support (oral supplements or tube feeding) to a control nutritional intervention enabling the satisfaction of energy requirements regardless of the use of high-calorie formula or placebo or no support for at least 4 weeks were considered eligible.

[The iodine prophylaxis: the experience in the Autonomous Province of Bolzano (South Tyrol).].

Since ancient times in South Tyrol there was evidence of endemic goitre caused by iodine deficiency. In the early 80's an epidemiological research on adults and primary and secondary school children reported in the least a prevalence of goitre from grade 1 B-3 (WHO) of 23,66% (limits WHO >5%) and an urinary iodine of 10,2 µgI/L. Therefore South Tyrol population presented heavy endemic goitre.

Cost-effectiveness of a disease-specific oral nutritional support for pressure ulcer healing.

Background & Aims: The Oligo Element Sore Trial has shown that supplementation with a disease-specific nutritional formula enriched with arginine, zinc, and antioxidants improves pressure ulcer (PU) healing in malnourished patients compared to an isocaloric-isonitrogenous support. However, the use of such a nutritional formula needs to be supported also by a cost-effectiveness evaluation.

Methods: This economic evaluation - from a local healthcare system perspective - was conducted alongside a multicenter, randomized, controlled trial following a piggy-back approach.

Energy balance in patients with pressure ulcers: a systematic review and meta-analysis of observational studies.

Medical nutrition therapy is reported to contribute to wound healing. However, effective intervention requires an accurate estimation of individual energy needs, which, in turn, relies on accurate methods of assessment. The primary aims of this systematic review and meta-analysis were to evaluate the resting energy expenditure (REE) of patients with pressure ulcers (PUs) compared to matched control groups and the potential estimation bias of REE predictive equations.

Awareness and knowledge about weight status and management: results from the 1 d sensitization campaign 'Obesity Day' in northern Italy.

Objective: To evaluate the awareness and knowledge about weight status and its management.

Design: A 1 d cross-sectional survey. Basic anthropometric assessments (weight, height, BMI and waist circumference) and a self-administered questionnaire were considered.

[The mediterranean diet model in inflammatory rheumatic diseases].

The Mediterranean diet is based on a pattern of eating closely tied to the Mediterranean region, which includes Greece and southern Italy. Essentially, the traditional diet emphasizes foods from plant sources, limited meat consumption, small amounts of wine and olive oil as the main fat source. The beneficial effects of the Mediterranean diet has been proven not only to cardiovascular diseases but also for diabetes, obesity, arthritis and cancer.

[Fish oil supplementation in rheumatoid arthritis].

The beneficial properties of fish oil are well known and are related to its fatty acid composition rich in omega-3 polyunsaturated fatty acids. In the last years a variety of epidemiological and clinical studies have demonstrated the efficacy of fish oil supplementation in the rheumatic diseases, in particular in rheumatoid arthritis. The anti-inflammatory effects of fish oil are linked to the production of alternative eicosanoids, to the reduction of proinflammatory cytokines, to the inhibition of the activation of T lymphocytes and of catabolic enzymes.

[Role of omega-3 polyunsaturated fatty acids in diet of patients with rheumatic diseases].

The beneficial effects of omega-3 polyunsaturated fatty acids have been widely described in the literature in particular those on cardiovascular system. In the last decade there has been an increased interest in the role of these nutrients in the reduction of articular inflammation as well as in the improvement of clinical symptoms in subjects affected by rheumatic diseases, in particular rheumatoid arthritis (RA). Nutritional supplementation with omega-3 may represent an additional therapy to the traditional pharmacological treatment due to the anti-inflammatory properties which characterize this class of lipids: production of alternative eicosanoids, reduction of inflammatory cytokines, reduction of T-lymphocytes activation, reduction of catabolic enzymes activity.

[Total parenteral nutrition in critical patients. The metabolic-nutritional aspects and effects on immune function of 2 different isocaloric-isonitrogenous regimens].

The aim of this investigation was to compare, in a randomized short-term study the effects on some parameters evaluating lipid metabolism, nutritional status and immune function of two different patients. Particularly, the influence of the intravenous (i.v.

[Trace nutrients in total enteral nutrition: the basal status and longitudinal course].

Introduction: Previous studies demonstrated deficiencies of selenium and other micronutrients in patients receiving total enteral nutrition (TEN). The content and bioavailability of trace elements in enteral formulas can be suboptimal.

Material And Methods: Basal blood levels of some trace elements (copper, iron, selenium, zinc) and vitamins (B12, folic acid) were determined in twenty patients at the beginning of TEN.

[Percutaneous endoscopic gastrostomy].

Surgical gastrostomies were first performed in the middle of the 19th century and modified during the following years, but the most important technical improvement was percutaneous endoscopic placement (PEG), in 1980 by Ponsky and Gauderer. This technique doesn't require anesthesia and it in possible also in patients with contraindications to surgical gastrostomy. The simple procedure involves a shorter hospitalization, lower risks and reduced costs.

[Possibilities and limitations of nutritional support in Crohn disease].

Crohn's disease involves a great risk of malnutrition. Malabsorption, bacterial contamination, frequent abdominal surgery, meal-related pain, protein loss through the damaged mucosa contribute to creating nutritional problems. Malnutrition can worsen the outcome, both in medical and surgical patients, and deteriorate an often already altered immune response.

[Enteral nutrition in the elderly].

Elderly is particularly at risk of malnutrition: he is not able to feed himself adequately, it is then important to attain correct intakes using also artificial enteral nutritional techniques (nasogastric tube, gastrostomy, etc.). These techniques may lead to complications (ab ingestis pneumonia, metabolic complications, alvus disorders): the use of artificially nutrition in the elderly must be carefully evaluated.

[Dietetic and pharmacologic treatment of hypercholesterolemia. Study of 32 patients over 14 months].

The aim of the study was to evaluate the effectiveness of dietetic-behavioural and pharmacological treatment on 32 patients with high level hypercholesterolemia (LDL-c greater than 160 mg/dl) over 14 months. Clinical and laboratory tests were performed at time 0 (enrollment), at time 1 (after 2 months dietetic-behavioural treatment only), at time 2 and time 3 (after 6 and 12 months respectively of combined dietetic-behavioural and pharmacological treatment). The dietetic-behavioural treatment consist of reduced intake of saturated fatty acids, cholesterol and rapidly absorbed glycid; increased intake of omega-3 fatty acids and fiber; reduced overall calorie intake.

[Nutritional assessment of aged patients with fractures of the proximal epiphysis of the femur].

Forty-two patients (M/F 9/33; age 78 +/- 10 years) were studied during Hospital stay for femoral neck fractures (16 neck, 26 pertrochanteric fractures). All underwent fracture surgery (internal fixation in 30, arthroplasty in 12 patients). Food intake was evaluated daily, supplemented with specific recipes.

[Nutritional support in non-Hodgkin's lymphoma treated with polychemotherapy MACOP-B cycle].

The collateral effects of antineoplastic therapy often lead to a deterioration of the cachectic condition induced by the presence of the tumour itself. This study analysed the effects of a programme of dietary surveillance/support in patients with non-Hodgkin's lymphoma undergoing a cycle of MACOP-B polychemotherapy. During the entire course of therapy patients were followed weekly by a nutritional specialist and a dietician in order to assess and if necessary modify food intake, also in relation to the onset of collateral effects.

[Nutrition therapy in patients with head and neck neoplasms].

The authors report the results of an open study carried out on 23 patients with head-neck neoplasia in order to test whether rational nutritional treatment can improve weight and clinical state. The data obtained would indicate that patients with nutritional intake higher than 26 kcal/kg of body weight underwent increase in body weight. The authors conclude that neoplastic patients, and in particular subjects affected by head-neck or cervico-facial neoplasia, need suitable nutritional intake.