Vol 7, No 1 (2026)

BACKGROUND: Dysphagia in children who have experienced critical illness is considered one of the manifestations of post–intensive care syndrome (PICS) and is associated with poorer survival outcomes. In pediatric practice, the prognostic value of the Functional Oral Intake Scale (FOIS) for early risk stratification of PICS-associated dysphagia remains understudied.

AIM: This study aimed to evaluate the discriminative ability of the FOIS for early diagnosis of dysphagia associated with PICS.

METHODS: A single-center cohort study involved 111 children who spent >72 hours the intensive care unit (ICU). Patients were stratified according to the development of PICS. The FOIS was assessed at admission, at 48 hours, 72 hours, on Day 7, and at discharge from the ICU; disease severity was evaluated using the FSS, pSOFA, and PRISM III scores. Correlation analysis, ROC analysis, and Kaplan–Meier curves were used to assess prognostic performance. The discriminative ability of the FOIS for predicting dysphagia development and the threshold score associated with swallowing recovery were determined.

RESULTS: Lower FOIS scores were associated with more severe functional impairment (inverse correlation with FSS, pSOFA, and PRISM III) and delayed recovery of independent oral intake. The FOIS score at 72 hours demonstrated the highest predictive accuracy for severe dysphagia, and a threshold of 4 points was associated with faster recovery of swallowing (AUC = 0.956; p < 0.001). Patients with a FOIS score of 4 at 72 hours after admission to the ICU demonstrated a high incidence of dysphagia at discharge.

CONCLUSIONS: Repeated assessment using the FOIS, particularly at 72 hours after ICU admission, is a clinically relevant tool for risk stratification and for planning rehabilitation and nutritional interventions in pediatric intensive care settings.

BACKGROUND: The global incidence of urolithiasis and obesity has been increasing, particularly in countries adopting a Western lifestyle. However, the role of dietary lipids in the development of urolithiasis remains insufficiently studied.

AIM: This work aimed to assess the impact of total fat, saturated fatty acids, and cholesterol intake on biochemical parameters of lithogenic metabolism in patients with urolithiasis.

METHODS: For a comprehensive assessment of dietary patterns, patients with urolithiasis were surveyed using an original questionnaire program. The questionnaire addressed the consumption of various food groups. Data on the chemical composition of foods were obtained from publicly available sources. Daily intake of fats, saturated fatty acids, and cholesterol was calculated based on reported consumption. Foods consumed more than once per month were included in the analysis. To evaluate lithogenic metabolism, serum and 24-hour urine levels of total calcium, phosphorus, urea, creatinine, chloride, magnesium, and uric acid were measured. The mineral composition of urinary calculi was determined by infrared spectroscopy using a reference spectral library of known stone composition. Patients were stratified according to stone composition (calcium oxalate, uric acid, and calcium phosphate). Comparative analysis of the mean intake of the studied nutrients and the associations between intake levels of fats, saturated fatty acids, and cholesterol and biochemical parameters of blood and urine was performed in these patient groups. Statistical analysis was conducted using Statistica 12.0 (StatSoft, USA) with parametric methods, including correlation analysis and the Student t test for independent samples. A significance level of p ≤ 0.05 was applied.

RESULTS: A total of 140 patients with urolithiasis were included: 67 men (47.9%) and 73 women (52.1%), aged 19 to 73 years. Stone composition was determined in all patients: calcium oxalate stones in 68 (48.6%), uric acid stones in 18 (12.9%), calcium phosphate stones in 44 (31.4%), and struvite stones in 10 (7.1%). In the overall cohort, mean intake of saturated fatty acids and cholesterol exceeded recommended levels: 37.82 ± 1.23 g and 347.98 ± 13.95 mg per day, respectively. No differences in intake between men and women were observed. High cholesterol intake had the greatest impact on metabolic parameters across most stone types.

CONCLUSIONS: Lipid intake may influence lithogenic metabolism depending on the chemical composition of urinary stones. When prescribing dietary interventions aimed at reducing intake of fats, saturated fatty acids, and cholesterol, the chemical composition of urinary stones should be taken into account.

The global prevalence of obesity has reached epidemic proportions, contributing to a substantial increase in chronic diseases and placing a growing burden on healthcare systems. This trend also leads to substantial economic challenges. This review focuses on metabolic disturbances associated with obesity and overweight. A search and analysis were conducted in PubMed and eLibrary databases for publications from 2005 to 2025. The analysis provides data on the prevalence of obesity and overweight across different regions worldwide among adults and children, as well as risks and diseases associated with metabolic disturbances. The role of adipose tissue–derived mediators (including cytokines and adipokines) in the development of pathological conditions is discussed. The contribution of macro- and micronutrient deficiencies to the development of diet-related diseases in individuals with obesity and overweight is described. Recommendations are provided for reducing the risk of metabolic disturbances through optimization of nutritional support. Based on the findings, abnormalities underlying metabolic syndrome are largely preventable and amenable to treatment. Effective management of obesity and overweight requires the development of a comprehensive strategy based on creating a health-promoting environment through population-wide health promotion and obesity prevention measures; targeted screening; timely and clearly regulated care for at-risk patients; and ensuring access to patient-centered healthcare services.