vitamin-b-12 and Dyspnea

Recent studies suggest that in utero exposure of methyl donors influences programming of the fetal immune system in favor of development of allergic disease. The aim of this study was to assess whether the MTHFR C677T polymorphism, folic acid supplementation, and circulating folate and vitamin B-12 concentrations during pregnancy were associated with wheezing, shortness of breath, and atopic dermatitis in offspring. The study was a population-based birth cohort from fetal life until 48 mo (n = 8742). The use of folic acid supplementation during pregnancy was assessed by questionnaire. Plasma folate and serum vitamin B-12 concentrations and the MTHFR C677T polymorphism were available from blood collected in early pregnancy. Atopic dermatitis, wheezing, and shortness of breath in the offspring were assessed by parental-derived questionnaires at 12, 24, 36, and 48 mo. Maternal folate >16.2 nmol/L and vitamin B-12 >178 pmol/L were positively associated with the development of atopic dermatitis [adjusted OR: 1.18 (95% CI: 1.05-1.33) and adjusted OR: 1.30 (95% CI: 1.06-1.60) for the highest quartiles of folate and vitamin B-12 concentrations, respectively] but not with wheezing and shortness of breath. Maternal MTHFR C677T polymorphism and folic acid supplementation were not associated with wheezing, shortness of breath, and atopic dermatitis. No interactions were found by age, family history of atopy, folic acid supplementation, MTHFR C677T polymorphism, or maternal smoking (P-interaction > 0.10). High folate and vitamin B-12 levels during pregnancy are associated with increased prevalence of atopic dermatitis in the offspring. Potential risks of high folate and vitamin B-12 concentrations on allergic outcomes should be evaluated when discussing mandatory fortification programs.

Topics: Child Development; Cohort Studies; Dermatitis, Atopic; Dietary Supplements; Dyspnea; Female; Folic Acid; Follow-Up Studies; Food, Fortified; Humans; Infant, Newborn; Male; Maternal Nutritional Physiological Phenomena; Methylenetetrahydrofolate Reductase (NADPH2); Netherlands; Polymorphism, Single Nucleotide; Pregnancy; Pregnancy Trimester, First; Prevalence; Prospective Studies; Respiratory Sounds; Vitamin B 12

Topics: Adult; Anemia, Pernicious; Blood Cell Count; Diagnosis, Differential; Dyspnea; Fatigue; Humans; Male; Methylmalonic Acid; Paresthesia; Vitamin B 12; Vitamin B 12 Deficiency

Bronchioloalveolar carcinoma (BAC) and adenocarcinoma mixed subtype with bronchioloalveolar features (ADC-WBF) represent a unique anatomo-clinical entity accounting for some 20% of non-small cell lung cancers (NSCLC). These tumors seem less sensitive to chemotherapy than other NSCLC. We report two cases of advanced ADC-WBF treated with second-line and fourth-line pemetrexed. Major and durable radiological response associated with clinical and functional improvement was achieved in both patients, without important drug toxicity. After treatment arrest, the two patients experienced progressive disease but responded to retreatment with pemetrexed. Recent data suggest that paclitaxel-based chemotherapy and epidermal growth factor receptor tyrosine kinase inhibitors could be an acceptable therapeutic strategy in unresectable CBA and ADC-WBF. The cases reported here and preclinical findings suggest a therapeutic efficacy of pemetrexed in these tumors. Prospective studies are required to evaluate this hypothesis.

Topics: Adenocarcinoma; Adenocarcinoma, Bronchiolo-Alveolar; Aged; Antimetabolites, Antineoplastic; Bone Neoplasms; Cough; Disease Progression; Dyspnea; Folic Acid; Glutamates; Guanine; Humans; Lung Neoplasms; Male; Neoplasm Staging; Neutropenia; Pemetrexed; Remission Induction; Renal Insufficiency; Smoking; Tomography, X-Ray Computed; Vitamin B 12

A 53-year-old woman was with adenocarcinoma of the lung metastatic to the brain was treated after several lines of chemotherapy with pemetrexed. After six cycles an impressive regression of the brain metastases was documented. A brief review of the literature on response of cerebral metastases to chemotherapy is added.

Topics: Adenocarcinoma; Antimetabolites, Antineoplastic; Brain Neoplasms; Chest Pain; Disease Progression; Dyspnea; Female; Folic Acid; Glutamates; Guanine; Headache; Humans; Lung Neoplasms; Magnetic Resonance Imaging; Middle Aged; Neoplasm Staging; Pemetrexed; Radiotherapy; Remission Induction; Smoking; Thoracic Surgery; Vitamin B 12

Topics: Administration, Oral; Aged; Anemia, Pernicious; Drug Hypersensitivity; Dyspnea; Female; Headache; Humans; Hydroxocobalamin; Middle Aged; Urticaria; Vitamin B 12