Background: The incidence of femoral intertrochanteric fractures in older adults is higher than that of femoral neck fractures;however, both conditions are often analyzed together as proximal femoral fractures. Consid...Background: The incidence of femoral intertrochanteric fractures in older adults is higher than that of femoral neck fractures;however, both conditions are often analyzed together as proximal femoral fractures. Considering the difference in treatment, postoperative complication, and mortality risk, these two fractures should be analyzed separately. This study aimed to analyze 1-year mortality and its risk factors in patients with surgically treated femoral intertrochanteric fractures. Methods: Consecutive patients with intertrochanteric fractures who underwent surgical interventions at our institution between January 2017 and December 2021 were retrospectively reviewed. A total of 238 patients were eligible for inclusion in this study. Patients’ demographic and clinical information were retrospectively collected. Patients were divided into the 1-year mortality (n = 16) and survival (n = 222) groups. The incidence of 1-year mortality and its independent risk factors were investigated using univariate and multivariate logistic regression analyses. Results: The mean age of patients was 85.6 ± 8.5 years. The 1-year mortality rate was 6.7% (16/238). Preoperative albumin level, the Geriatric Nutritional Risk Index (GNRI), and malnutrition status (GNRI p = 0.02, p = 0.02, and p = 0.0011, respectively). Multivariate analysis showed that malnutrition status (GNRI p = 0.035) was an independent risk factor for 1-year mortality. Conclusion: Malnutrition status assessed using GNRI (GNRI < 92) was an independent risk factor for 1-year mortality. Our findings suggest that GNRI may be an effective screening tool for predicting postoperative 1-year mortality of patients with surgically treated femoral intertrochanteric fractures.展开更多
Introduction: Malnutrition is a pathological state resulting from the relative deficiency or excess of one or more essential nutrients, whether manifested clinically or detected only by biochemical, anthropometric or ...Introduction: Malnutrition is a pathological state resulting from the relative deficiency or excess of one or more essential nutrients, whether manifested clinically or detected only by biochemical, anthropometric or physiological analyses. The overall objective was to assess the quality of management of acute malnutrition in children aged 0 - 24 months at the Boulbinet health center. Methodology: This was a prospective descriptive study lasting six (06) months from May 5 to October 5, 2018. The study included all children aged 0 to 24 months. Results: Acute malnutrition in children aged 0 - 24 months accounted for 2.11% of cases. The sex ratio was 1.41 in favor of males. The mean age of our patients was 5 months 7 days, with extremes of 1 month and 6 months. The majority came from Ra toma (40.24%). Exclusive breastfeeding was most common (54.02%). The main clinical signs were: pallor 49.42%, diarrhea 46.67, oral lesions37.96%. SAM represented 89.66% and MAM 10.34%. Most associated pathologies: anemia 49.42% and oral candidiasis 37.93%. In terms of outcome, we recorded 56.32% cures, 20.69% deaths, 18.39% dropouts and 4.60% cures. Conclusion: Improving the quality of care for malnourished children aged 0 - 24 months requires raising awareness among mothers and the general public of the consequences of malnutrition.展开更多
Malnutrition is a common complication in patients with malignant tumors and adversely affects treatment and prognosis1.It has been reported that the global prevalence of malnutrition in hospitalized patients with mali...Malnutrition is a common complication in patients with malignant tumors and adversely affects treatment and prognosis1.It has been reported that the global prevalence of malnutrition in hospitalized patients with malignant tumors is approximately 70%2.Moreover,approximately 20%of cancer patient deaths are directly attributable to malnutrition3.According to the Investigation on Nutrition Status and its Clinical Outcome of Common Cancers(INSCOC)project4,the overall prevalence of malnutrition in Chinese inpatients with common malignant tumors is 80.4%.Of the 58.展开更多
Introduction: Child malnutrition is a major public health concern worldwide, particularly in low- and middle-income countries. The latest report from Senegal’s Continuous Demographic and Health Survey revealed that 1...Introduction: Child malnutrition is a major public health concern worldwide, particularly in low- and middle-income countries. The latest report from Senegal’s Continuous Demographic and Health Survey revealed that 18% of children in Senegal were stunted (chronic malnutrition), 8% were wasted (acute malnutrition) and 14% were underweight. Thus, this study aimed to assess the characteristics associated with malnutrition in children according to their nutritional status. Methods: This descriptive transverse study was conducted at the Pediatric Social Institute of Pikine/Guediawaye and the National Hospital Center of Pikine, in Senegal between October and December 2019. A total of 94 children were recruited, with the consent of their legal tutors. Descriptive and multivariate analyses of the factors associated with malnutrition were performed. The z-scores for the indices of nutrition were determined with WHO Anthro<sup>®</sup> software version 3.2.2. All the data analyses were performed using R software version 4.2.2. Result: From the 94 children recruited, 51.06% were female, with a sex ratio (male/female) of 0.96. Acute malnutrition was recorded in 62.77% of cases, chronic malnutrition in41.49%, and underweight in 71.27%. Linear regression analysis showed that many factors, such as the female gender [OR = 1.82 CI (1.02 - 3.3), P-value = 0.04], consanguinity [OR = 2.84 CI (1.14 - 7.65), P-value = 0.03], low birth weight [OR = 4.83 CI (2.15 - 12.89), P-value = 0.0004], were associated with acute malnutrition. Low birth weight (<2.5 kg) [OR = 10.66 CI (3.82 - 44.39) P-value < 0.0001], non-exclusive breastfeeding [OR = 3 CI (1.40 - 7.13)] P-value = 0.007], dietary diversification before six months [OR = 2.04 CI (1.23 - 3.51), P-value = 0.007] and others factors were associated with underweight. The most frequently recorded clinical signs are weight loss (30.85%), fever (23.40%), diarrhea (34.04%), and anemia (70.21%). Conclusion: Problems associated with malnutrition are multifactorial. Dietary diversification, consanguinity, and low birth weight are factors associated with malnutrition in children in Senegal. Thus, special attention must be paid to this problem because of its impact on child survival. .展开更多
In recent years, there has been growing interest in the emergence of double burden of malnutrition (DBM) in Africa. In this study, we reviewed the literature on double burden of malnutrition in households, reviewing p...In recent years, there has been growing interest in the emergence of double burden of malnutrition (DBM) in Africa. In this study, we reviewed the literature on double burden of malnutrition in households, reviewing previous studies investigating the prevalence of DBM in Africa and the factors associated with it. To identify relevant studies, we consulted the PubMed and Cochrane electronic databases, using specific search terms. A total of seventeen articles met the eligibility criteria. These articles were published between 2012 and 2022, and their data were collected between 2000 and 2019. Twelve of these studies used secondary data, including demographic and health surveys. The age of children and adults varied from study to study. All studies used Body Mass Index as a nutritional indicator for adults. For children, the height-for-age Z-score was most commonly used, while weight-for-age, weight-for-height and Body Mass Index-for-age were less commonly used. The national prevalence of double nutritional burden in households ranged from 1.71% to 38.7%, depending on the country and the year. However, direct comparisons between studies were limited due to differences in combinations of undernutrition, overweight or obesity. Among the factors associated with double nutritional burden within households, the most frequently cited in the selected articles were urban/rural residence, income or socioeconomic status, age of child and mother, household size and mother’s level of education. However, no study assessed physical activity, and very few examined the diet of household members. It is essential to take these different parameters into account when designing and implementing interventions to prevent the DBM in Africa. Community and societal factors will also need to be studied and taken into account in these interventions.展开更多
Objective:This study aimed to have a good knowledge of heart failure complicated with malnutrition research status,hotspots,and forecast research trends using bibliometric analysis and visualization of studies of hear...Objective:This study aimed to have a good knowledge of heart failure complicated with malnutrition research status,hotspots,and forecast research trends using bibliometric analysis and visualization of studies of hear t failure complicated with malnutrition in the past 10 years.Methods:Ar ticles related to malnutrition-induced hear t failure were obtained from the Web of Science Core Collection(Wo SCC)series from January 2012 to January 2022.Two software(Java Cite Space 5.8R3 and Microsoft Excel 2019)were used to perform bibliometric and knowledge-map analysis,including analyzing the annual publication and trend of ar ticles,authors and co-cited authors,institutions/countries,co-cited journals,co-occurrence,clusters,and burst of keywords,co-cited references,and reference burst.Results:A total of 672 articles appeared in 180 scientific journals by 4249 authors from 1453 institutions in 71 countries.Over the past 10 years,the number of related studies released has shown an upward trend,and the range of increases has been larger over the past 5 years.Takatoshi Kasai released the most papers,while Anker S D had the most co-quotes.Simultaneously,active cooperation existed in complicated hear t failure with researchers on malnutrition.Circulation,Journal of The American College of Cardiology,and Clinical Nutrition were the top 3 co-cited journals.The USA,Japan,and China were the most productive countries,while Johns Hopkins University was the most active institution.In addition,the reference published by Ponikowski P had the most co-citations,relating to as a knowledge base.The latest hotspots of hear t failure complicated with malnutrition mainly included research on:(1)assessment of nutrition status,the impact/risk factor of nutrition,and the prevalence and outcome of the patients;(2)hear t failure complicated with malnutrition when complicated with other diseases,for example,chronic kidney disease and diabetes mellitus;(3)the nutrition of child patients with heart failure complicated with malnutrition;and(4)the treatment of heart failure complicated with malnutrition,including assist devices,organ transplantation,and drug therapy.While the frontier topics included research on:(1)the index of hear t failure complicated with malnutrition;(2)the effect of sarcopenia to hear t failure complicated with malnutrition patients and the use of geriatric nutritional risk index to assess the nutritional statue;and(3)find the nutritional risk index.Conclusions:This study conducted a full overview of the present research situation,hotspots,and frontiers by using bibliometric and visualization analysis methods in hear t failure complicated with malnutrition,which would provide a helpful reference for future research.展开更多
Introduction: In Chad, malnutrition is a silent emergency. Yet the use of local products in the fight against malnutrition is essential. The purpose of this study was to compare the efficacy of locally sourced enriche...Introduction: In Chad, malnutrition is a silent emergency. Yet the use of local products in the fight against malnutrition is essential. The purpose of this study was to compare the efficacy of locally sourced enriched flour in the recovery of children 6 to 59 months of moderate acute malnourishment compared to Ready-to-Use Therapeutic Foods (Plumpy’ Sup) in the city of Abéché-Chad. Methodology: This study took place from 1 October 2021 to 31 January 2022 in the city of Abéché, capital of the province of Ouaddaï. It was conducted in eight (8) urban health centers in the city of Abéché and concerned eighty (80) children with moderate acute malnutrition. It was based on a consumption assessment of two complementary foods by two groups of children. The assessment of nutritional status was made through anthropometric data such as weight, height and brachial perimeter. Results: All 80 children were tested for moderate acute malnutrition. Two complementary foods have been used which are locally produced flour and the Ready-to-Use Therapeutic Food. The study showed that the group 1 who consumed the locally produced flour had an average weight gain of 1100 g and the group 2 who consumed the Plumpy sup had an average weight gain of 400 g. Conclusion: The present study carried out in Abéché allowed us to compare the effectiveness of locally produced weaning flours with Ready-to-Use Therapeutic Foods on moderate malnourished child weight growth in the nutritional units of the town of Abéché.展开更多
Introduction: Malnutrition is a public health problem. It is responsible for high morbidity and mortality in children aged 6 - 59 months. The aim of this study was to determine the outcome of children with complicated...Introduction: Malnutrition is a public health problem. It is responsible for high morbidity and mortality in children aged 6 - 59 months. The aim of this study was to determine the outcome of children with complicated severe acute malnutrition after hospital discharge. Methods: This is a descriptive and analytical cross-sectional study conducted from March 1 to November 31, 2021 at the Albert Royer Children’s Hospital. Children discharged from hospital for complicated severe acute malnutrition were included. Results: A total of 103 children were included. The mean age of children at hospitalization was 16.41 ± 10.11 months and mean duration of follow-up after hospital discharge was 29.63 ± 8.59 months. Three children (2.91%) died after hospital discharge. The mean z-score of the weight-for-current height was -1.34 ± 1.08. Almost a quarter (24.27%) of the children remain acute malnourished with 3.88% of severe acute malnutrition (SAM). The predictors’ factors associated with non-response were weaning before 2 years of age (ORaj: 12.21;95% CI [6.82 - 18.44];p = 0.04) and tuberculosis (ORaj: 21.06;95% CI [12.54 - 41.09];p = 0.03). Conclusion: The rate of recovery of nutritional status in children with complicated severe acute malnutrition is satisfactory. Ablactation before the age of two and the existence of tuberculosis are significantly associated with non-recovery of nutritional status.展开更多
Introduction: Severe acute malnutrition (SAM) is one of the main public health problems in the world. It is responsible in addition to the general symptoms, vitamin A deficiency which can cause serious eye damage incl...Introduction: Severe acute malnutrition (SAM) is one of the main public health problems in the world. It is responsible in addition to the general symptoms, vitamin A deficiency which can cause serious eye damage including keratomalacia. This work aims to study possible ophthalmological lesions in severely acutely malnourished children from 0 to 60 months. Patients and Method: This study was carried out in a secondary ophthalmology center. It concerned all severely acute malnourished patients admitted for consultation in the pediatric department. Results: A total of 174 eyes of 87 children aged 0 to 60 months were examined. Two-thirds of the patients were aged between 6 and 18 months. Palpebral lesions are rare, however, we observed 12.64% blepharitis and palpebral dermatitis. Ocular involvement due to vitamin A deficiency was 6.9%, including one case of BITOT SPOT, 4 cases of conjunctival xerosis and one case of keratomalacia. Conclusion: Xerophthalmia is an ocular lesion due to a dietary intake deficient in vitamin A that occurs during severe acute malnutrition. Its occurrence is increasingly rare even in developing countries. However, some cases are observed in practice and may be responsible for profound visual impairments.展开更多
Introduction: Severe acute malnutrition (SAM) is one of the main public health problems in the world. It is responsible in addition to the general symptoms, vitamin A deficiency which can cause serious eye damage incl...Introduction: Severe acute malnutrition (SAM) is one of the main public health problems in the world. It is responsible in addition to the general symptoms, vitamin A deficiency which can cause serious eye damage including keratomalacia. This work aims to study possible ophthalmological lesions in severely acutely malnourished children from 0 to 60 months. Patients and Method: This study was carried out in a secondary ophthalmology center. It concerned all severely acute malnourished patients admitted for consultation in the pediatric department. Results: A total of 174 eyes of 87 children aged 0 to 60 months were examined. Two-thirds of the patients were aged between 6 and 18 months. Palpebral lesions are rare, however, we observed 12.64% blepharitis and palpebral dermatitis. Ocular involvement due to vitamin A deficiency was 6.9%, including one case of BITOT SPOT, 4 cases of conjunctival xerosis and one case of keratomalacia. Conclusion: Xerophthalmia is an ocular lesion due to a dietary intake deficient in vitamin A that occurs during severe acute malnutrition. Its occurrence is increasingly rare even in developing countries. However, some cases are observed in practice and may be responsible for profound visual impairments.展开更多
Background:To examine the correlation between the dietary mineral intake and the nutritional status of patients suffering from malignan-cies.Methods:This multi-center cross-sectional study included a total of 866 pati...Background:To examine the correlation between the dietary mineral intake and the nutritional status of patients suffering from malignan-cies.Methods:This multi-center cross-sectional study included a total of 866 patients with malignant tumors recruited from seven hospitals throughout China.The information of socio-demographic characteristics and biochemical indicators were obtained from electronic medical records of inpatients.Dietary data were collected using a 3-day 24-hour dietary recall questionnaire.The intake of energy,dietary calcium(Ca),phosphorus(P),potassium(K),sodium(Na),magnesium(Mg),iron(Fe),zinc(Zn),selenium(Se),copper(Cu)and manganese(Mn)were estimated according to the Chinese Food Composition Tables standard edition.The weight and height of patients were measured,and the body mass index(BMI)was calculated.Nutritional risk and malnutrition were assessed by the Nutritional Screening 2002(NRS 2002)and Global Leadership Initiative on Malnutrition(GLIM)diagnostic criteria.We used a multivariable logistic regression model to estimate the asso-ciations between dietary minerals and malnutrition.Results:The patients had an average age of 61.98(±15.49)years,and 40.6%(n=352)were female.Slightly less than half(44.5%)of the patients were at nutritional risk(NRS 2002≥3),and 32.7%were diagnosed with malnutrition(using the GUM criteria).Univariate analy-ses revealed that there was a statistically significant relationship between dietary mineral intake and the occurrence of nutritional risk(P<0.001).After adjusting the collinearity,we found that higher levels of P,Mn and Se intake were negatively associated with nutritional risk as-sessed by the NRS 2002 score.Moderate intake of Ca and high intake of Zn might also decrease the nutritional risk(Ca:OR,0.53,95%CI,0.32-0.88;Zn:OR,0.36,95%CI,0.19-0.68).However,no significant relationships were observed between any dietary mineral intake and malnutrition identified by the GUM criteria.Conclusions:Dietary minerals,especially P,Se,and Mn,may have a protective effect on the occurrence of nutritional risk in patients with malignant tumors.In addition,patients should maintain appropriate levels of Ca and Zn.展开更多
Head and neck cancer and the approaches used to treat it can cause symptoms such as mucositis,alteration or loss of taste,dysphagia,and xerostomia,whichmakes the incidence of malnutrition in head and neck cancer patie...Head and neck cancer and the approaches used to treat it can cause symptoms such as mucositis,alteration or loss of taste,dysphagia,and xerostomia,whichmakes the incidence of malnutrition in head and neck cancer patients higher than in the general population of cancer patients.Malnutrition in patients with head and neck cancer is associated with the occurrence of treatment-related adverse events,an increase in overall economic cost,a decline in quality of life,and a poor prognosis.Therefore,rehabilitation interventions for malnutrition are necessary throughout the course of the disease.However,the importance of rehabilitation interventions for malnutrition in patients with head and neck cancer has not been fully recognized,and the optimal methods and timing of interventions are unclear.This article provides an overview of rehabilitation interventions for malnutrition,including nutritional supplementation,exercise-based interventions,nutritional counseling and cognitive improvement,and drug therapy,and discusses their advantages and disadvantages as well as potential future directions.展开更多
Primary biliary cholangitis(PBC)is a chronic cholestatic liver disease that is associated with impaired biliary excretion processes.Along with the development of cholestasis,there is a deficient flow of bile acids int...Primary biliary cholangitis(PBC)is a chronic cholestatic liver disease that is associated with impaired biliary excretion processes.Along with the development of cholestasis,there is a deficient flow of bile acids into the intestinal lumen causing malnutrition(MN)that is manifested in deficiencies of both macro-and micronutrients.The mechanism for development of trophological insufficiency is multifactorial.However,the trigger of MN in PBC is impaired enterohepatic circulation of bile acids.The ingress of bile acids with a detergent effect into the general bloodstream,followed by elimination via the kidneys and skin,triggers a cascade of metabolic disturbances,which leads to the gradual development and progression of calorie MN.The latter gradually transforms into protein-calorie MN(PСM)(as marasmus)due to the insufficient entry of bile acids into the duodenum,which is accompanied by a decrease in the emulsification,hydrolysis,and absorption of fats and fat-soluble vitamins,as well as disturbance of intestinal motility and bacterial overgrowth.Fat-soluble vitamin deficiencies complement PСM with vitamin and mineral MN.The development of hepatocellular failure enhances the progression of PСM due to the impaired protein synthetic function of hepatocytes in the advanced stage of PBC,which results in deficiency of not only the somatic but also the visceral pool of proteins.A mixed PСM form of marasmus and kwashiorkor develops.Early recognition of energy,protein,micronutrient,and macronutrient deficiencies is of great importance because timely nutritional support can improve liver function and quality of life in patients with PBC.In this case,it is important to know what type(energy,proteincalorie,vitamin,and vitamin-mineral)and form(marasmus,marasmuskwashiorkor)of MN is present in the patient and how it is associated with the stage of the disease.Therefore,it is recommended to screen all patients with PBC for MN,from the early asymptomatic stage of the disease in order to identify and avoid preventable complications,such as fatigue,malaise,performance decrement,sarcopenia,osteoporosis,and hepatic encephalopathy,which will be able to provide appropriate nutritional support for correction of the trophological status.展开更多
Objective According to literature,cancer patients have the highest incidence of malnutrition among hospital patients(40%-80%).Despite this high prevalence,this condition is still under-diagnosed.The aim of this study ...Objective According to literature,cancer patients have the highest incidence of malnutrition among hospital patients(40%-80%).Despite this high prevalence,this condition is still under-diagnosed.The aim of this study was to conduct a systematic literature review and meta-analysis to assess the diagnostic performance of the Malnutrition Screening Tool(MST),a simple tool that can be applied in a busy setting where a comprehensive assessment at screening would be impractical.Methods PubMed,EMBASE and Cochrane central register of controlled trials were systematically searched to identify records relevant to the research question.The QUADAS-2 was used to assess the quality of each included study and the meta-analysis was conducted using the hierarchical bivariate model in STATA.Results Seven records were included in this study and the overall sensitivity specificity,diagnostic odds ratio(DOR).The pooled sensitivity and specificity generated after the meta-analysis in STATA were 0.78(95%CI:0.64-0.88)and 0.82(95%CI:0.76-0.87),respectively.The corresponding DOR was 16.33(95%CI:7.08-37.67).The positive likelihood ratio(LR+)was+4.39(95%CI:3.02-6.38),and the negative likelihood ratio(LR-)were 0.27(95%CI:0.16-0.47)and the 1/LR-3.72(2.14-6.46).Conclusion These results showed that the MST provides weak diagnostic evidence when used to screen for malnutrition in adult cancer patients.展开更多
AIM: To evaluate the prevalence of preoperative and postoperative malnutrition and the relationships between objective and subjective nutritional assessment of gastric cancer patients. METHODS: From October 2005 to Ju...AIM: To evaluate the prevalence of preoperative and postoperative malnutrition and the relationships between objective and subjective nutritional assessment of gastric cancer patients. METHODS: From October 2005 to July 2006, we studied 80 patients with no evidence of recurrent disease and no loss to follow-up after curative surgery for gastric cancer. In this group, 9 patients underwent total gastrectomy and 71 patients subtotal gastrectomy. At admission, 6 and 12 mo after surgery, the patients were assessed on the subjective global assessment (SGA), nutritional risk screening (NRS-2002), nutritional risk index (NRI) and by anthropometric measurements and laboratory data. Differences between the independent groups were assessed with the Student's t test and oneway analysis of variance. Spearman's rank correlation coefficients were calculated to evaluate the association between the scores and variables. RESULTS: The prevalence of malnutrition at admissionwas 31% by SGA and 43% by NRS-2002. At admission, the anthropometric data were lower in the malnourished groups defined by the SGA and NRS-2002 assessments, but did not differ between the groups using the NRI assessment. Body weight (BW), body mass index (BMI), triceps skin fold and midarm circumference were significantly reduced, but the total lymphocyte count, albumin, protein, cholesterol and serum iron levels did not decrease during the postoperative period. Six months after surgery, there was a good correlation between the nutritional assessment tools (SGA and NRS-2002) and the other nutritional measurement tools (BW, BMI, and anthropometric measurements). However, 12 mo after surgery, most patients who were assessed as malnourished by SGA and NRS-2002 had returned to their preoperative status, although their BW, BMI, and anthropometric measurements still indicated a malnourished status. CONCLUSION: A combination of objective and subjective assessments is needed for the early detection of the nutritional status in case of gastric cancer patients after gastrectomy.展开更多
Objective Nutrition is closely related to the health of the elderly population. This study aimed to provide a comprehensive picture of the nutrition status of elderly Chinese and its related dietary,geographical, and ...Objective Nutrition is closely related to the health of the elderly population. This study aimed to provide a comprehensive picture of the nutrition status of elderly Chinese and its related dietary,geographical, and socioeconomic factors.Methods A total of 13,987 ≥ 60-year-old persons from the 2010–2013 Chinese National Nutrition and Health Survey were included to evaluate various aspects of malnutrition, including underweight,overweight or obesity, and micronutrient inadequacy.Results Overall, the prevalence of obesity, overweight, and underweight was 12.4%, 34.8%, and 5.7%,respectively, with disparities both geographically and socioeconomically. The prevalence of underweight was higher among the older old(≥ 75 years), rural residents and those with low income, with low education status, and residing in undeveloped West areas. More than 75% of the elderly do not meet the Dietary Reference Intakes for vitamins A, B1, B2, and E, folate, calcium, selenium, potassium, biotin,and choline, with the prevalence of inadequate intake increasing with age for most nutrients. At the population level, the mean intakes of numerous food groups did not meet the recommendations by the Chinese Dietary Guideline.Conclusions Obesity epidemic, inadequacy of micronutrient intake, and high prevalence of underweight and anemia in susceptible older people are the major nutrition challenges for the rapidly aging population in China.展开更多
Malnutrition is highly prevalent in liver cirrhosis and its presence carries important prognostic implications.The clinical conditions and pathophysiological mechanisms that cause malnutrition in cirrhosis are multipl...Malnutrition is highly prevalent in liver cirrhosis and its presence carries important prognostic implications.The clinical conditions and pathophysiological mechanisms that cause malnutrition in cirrhosis are multiple and interrelated.Anorexia and liver decompensation symptoms lead to poor dietary intake;metabolic changes characterised by elevated energy expenditure,reduced glycogen storage,an accelerated starvation response and protein catabolism result in muscle and fat wasting;and,malabsorption renders the cirrhotic patient unable to fully absorb or utilise food that has been consumed.Malnutrition is therefore a considerable challenge to manage effectively,particularly as liver disease progresses.A high energy,high protein diet is recognised as standard of care,yet patients struggle to follow this recommendation and there is limited evidence to guide malnutrition interventions in cirrhosis and liver transplantation.In this review,we seek to detail the factors which contribute to poor nutritional status in liver disease,and highlight complexities far greater than“poor appetite”or“reduced oral intake”leading to malnutrition.We also discuss management strategies to optimise nutritional status in this patient group,which target the inter-related mechanisms unique to advanced liver disease.Finally,future research requirements are suggested,to develop effective treatments for one of the most common and debilitating complications afflicting cirrhotic patients.展开更多
Malnutrition is a highly prevalent and under recognized condition in developing countries of South Asia.The presence of malnutrition causes a severe impact on patients with liver cirrhosis.The etiology of cirrhosis di...Malnutrition is a highly prevalent and under recognized condition in developing countries of South Asia.The presence of malnutrition causes a severe impact on patients with liver cirrhosis.The etiology of cirrhosis differs in the South Asian region compared to the West,with hepatitis B and C still being the leading causes and the prevalence of nonalcoholic fatty liver disease increasing over time.Comorbid malnutrition worsens outcomes for cirrhosis patients.Urgent attention to address malnutrition is needed to improve patient outcomes.The etiology and pathophysiology of malnutrition in liver diseases is multifactorial,as reduction in liver function affects both macronutrients and micronutrients.A need for nutritional status assessment for liver disease patients exists in all parts of the world.There are many widely studied tools in use to perform a thorough nutritional assessment,of which some tools are low cost and do not require extensive training.These tools can be studied and evaluated for use in the resource limited setting of a country like Pakistan.Treatment guidelines for proper nutrition maintenance in chronic liver disease exist for all parts of the world,but the knowledge and practice of nutritional counseling in Pakistan is poor,both amongst patients and physicians.Emphasis on assessment for nutritional status at the initial visit with recording of vital signs is needed.Simultaneously,treating physicians need to be made aware of the misconceptions surrounding nutritional restrictions in cirrhosis so that patient education is done correctly based on proper scientific evidence.展开更多
AIM: To investigate the prevalence of undernutrition, risk of malnutrition and obesity in the Italian gastroenterological population. METHODS: The Italian Hospital Gastroenterology Association conducted an observation...AIM: To investigate the prevalence of undernutrition, risk of malnutrition and obesity in the Italian gastroenterological population. METHODS: The Italian Hospital Gastroenterology Association conducted an observational, cross-sectional multicenter study. Weight, weight loss, and body mass index were evaluated. Undernutrition was defined as unintentional weight loss > 10% in the last threesix months. Values of Malnutrition Universal Screening Tool(MUST) > 2, NRS-2002 > 3, and Mini Nutritional Assessment(MNA) from 17 to 25 identified risk of malnutrition in outpatients, inpatients and elderly patients, respectively. A body mass index ≥ 30 indicated obesity. Gastrointestinal pathologies were categorized into acute, chronic and neoplastic diseases. RESULTS: A total of 513 patients participated in the study. The prevalence of undernutrition was 4.6% in outpatients and 19.6% in inpatients. Moreover, undernutrition was present in 4.3% of the gastrointestinal patients with chronic disease, 11.0% of those with acute disease, and 17.6% of those with cancer. The risk of malnutrition increased progressively and significantly in chronic, acute and neoplastic gastrointestinal diseases in inpatients and the elderly population. Logistical regression analysis confirmed that cancer was a risk factor for undernutrition(OR = 2.7; 95%CI: 1.2-6.44, P = 0.02). Obesity and overweight were more frequent in outpatients. CONCLUSION: More than 63% of outpatients and 80% of inpatients in gastroenterological centers suffered from significant changes in body composition and required specific nutritional competence and treatment.展开更多
Background: Diabetes means the blood glucose, which is too high or too low. With Type 2 DM, the more common type, the body does not make or use insulin well. In patients with DM, Helicobacter pylori is one of the most...Background: Diabetes means the blood glucose, which is too high or too low. With Type 2 DM, the more common type, the body does not make or use insulin well. In patients with DM, Helicobacter pylori is one of the most common infections worldwide. Available data on the possible association between H. pylori infection and DM are contradictory. There are a few studies in the Middle East, and this study is the pioneer study, in the Medical Services Clinics in Gaza strip. Aims: This study was conducted to reveal the prevalence of H. pylori infection, malnutrition, insulin resistance among T2DM patients, to describe the dietary requirements of T2DM patients, finally to evaluate the current information about diet, and lifestyle in the prevention of H. pylori, and malnutrition. Methodology: A cross-sectional study was conducted in the Medical Services Clinics in Gaza Strip, and there were 129 patients included in this study. Data were collected through hematological information and structured interview questionnaire. Results: Highly significant percentage of H. pylori (70%) among the DM patients includes in the study, but not indicates any significant association between gender and H. pylori status. Conclusion: H. pylori patients should update their sugar level values in the record, and should get exercise and diet plan for every meal.展开更多
文摘Background: The incidence of femoral intertrochanteric fractures in older adults is higher than that of femoral neck fractures;however, both conditions are often analyzed together as proximal femoral fractures. Considering the difference in treatment, postoperative complication, and mortality risk, these two fractures should be analyzed separately. This study aimed to analyze 1-year mortality and its risk factors in patients with surgically treated femoral intertrochanteric fractures. Methods: Consecutive patients with intertrochanteric fractures who underwent surgical interventions at our institution between January 2017 and December 2021 were retrospectively reviewed. A total of 238 patients were eligible for inclusion in this study. Patients’ demographic and clinical information were retrospectively collected. Patients were divided into the 1-year mortality (n = 16) and survival (n = 222) groups. The incidence of 1-year mortality and its independent risk factors were investigated using univariate and multivariate logistic regression analyses. Results: The mean age of patients was 85.6 ± 8.5 years. The 1-year mortality rate was 6.7% (16/238). Preoperative albumin level, the Geriatric Nutritional Risk Index (GNRI), and malnutrition status (GNRI p = 0.02, p = 0.02, and p = 0.0011, respectively). Multivariate analysis showed that malnutrition status (GNRI p = 0.035) was an independent risk factor for 1-year mortality. Conclusion: Malnutrition status assessed using GNRI (GNRI < 92) was an independent risk factor for 1-year mortality. Our findings suggest that GNRI may be an effective screening tool for predicting postoperative 1-year mortality of patients with surgically treated femoral intertrochanteric fractures.
文摘Introduction: Malnutrition is a pathological state resulting from the relative deficiency or excess of one or more essential nutrients, whether manifested clinically or detected only by biochemical, anthropometric or physiological analyses. The overall objective was to assess the quality of management of acute malnutrition in children aged 0 - 24 months at the Boulbinet health center. Methodology: This was a prospective descriptive study lasting six (06) months from May 5 to October 5, 2018. The study included all children aged 0 to 24 months. Results: Acute malnutrition in children aged 0 - 24 months accounted for 2.11% of cases. The sex ratio was 1.41 in favor of males. The mean age of our patients was 5 months 7 days, with extremes of 1 month and 6 months. The majority came from Ra toma (40.24%). Exclusive breastfeeding was most common (54.02%). The main clinical signs were: pallor 49.42%, diarrhea 46.67, oral lesions37.96%. SAM represented 89.66% and MAM 10.34%. Most associated pathologies: anemia 49.42% and oral candidiasis 37.93%. In terms of outcome, we recorded 56.32% cures, 20.69% deaths, 18.39% dropouts and 4.60% cures. Conclusion: Improving the quality of care for malnourished children aged 0 - 24 months requires raising awareness among mothers and the general public of the consequences of malnutrition.
基金supported by the National Key Research and Development Program(Grant No.2022YFC2009600)。
文摘Malnutrition is a common complication in patients with malignant tumors and adversely affects treatment and prognosis1.It has been reported that the global prevalence of malnutrition in hospitalized patients with malignant tumors is approximately 70%2.Moreover,approximately 20%of cancer patient deaths are directly attributable to malnutrition3.According to the Investigation on Nutrition Status and its Clinical Outcome of Common Cancers(INSCOC)project4,the overall prevalence of malnutrition in Chinese inpatients with common malignant tumors is 80.4%.Of the 58.
文摘Introduction: Child malnutrition is a major public health concern worldwide, particularly in low- and middle-income countries. The latest report from Senegal’s Continuous Demographic and Health Survey revealed that 18% of children in Senegal were stunted (chronic malnutrition), 8% were wasted (acute malnutrition) and 14% were underweight. Thus, this study aimed to assess the characteristics associated with malnutrition in children according to their nutritional status. Methods: This descriptive transverse study was conducted at the Pediatric Social Institute of Pikine/Guediawaye and the National Hospital Center of Pikine, in Senegal between October and December 2019. A total of 94 children were recruited, with the consent of their legal tutors. Descriptive and multivariate analyses of the factors associated with malnutrition were performed. The z-scores for the indices of nutrition were determined with WHO Anthro<sup>®</sup> software version 3.2.2. All the data analyses were performed using R software version 4.2.2. Result: From the 94 children recruited, 51.06% were female, with a sex ratio (male/female) of 0.96. Acute malnutrition was recorded in 62.77% of cases, chronic malnutrition in41.49%, and underweight in 71.27%. Linear regression analysis showed that many factors, such as the female gender [OR = 1.82 CI (1.02 - 3.3), P-value = 0.04], consanguinity [OR = 2.84 CI (1.14 - 7.65), P-value = 0.03], low birth weight [OR = 4.83 CI (2.15 - 12.89), P-value = 0.0004], were associated with acute malnutrition. Low birth weight (<2.5 kg) [OR = 10.66 CI (3.82 - 44.39) P-value < 0.0001], non-exclusive breastfeeding [OR = 3 CI (1.40 - 7.13)] P-value = 0.007], dietary diversification before six months [OR = 2.04 CI (1.23 - 3.51), P-value = 0.007] and others factors were associated with underweight. The most frequently recorded clinical signs are weight loss (30.85%), fever (23.40%), diarrhea (34.04%), and anemia (70.21%). Conclusion: Problems associated with malnutrition are multifactorial. Dietary diversification, consanguinity, and low birth weight are factors associated with malnutrition in children in Senegal. Thus, special attention must be paid to this problem because of its impact on child survival. .
文摘In recent years, there has been growing interest in the emergence of double burden of malnutrition (DBM) in Africa. In this study, we reviewed the literature on double burden of malnutrition in households, reviewing previous studies investigating the prevalence of DBM in Africa and the factors associated with it. To identify relevant studies, we consulted the PubMed and Cochrane electronic databases, using specific search terms. A total of seventeen articles met the eligibility criteria. These articles were published between 2012 and 2022, and their data were collected between 2000 and 2019. Twelve of these studies used secondary data, including demographic and health surveys. The age of children and adults varied from study to study. All studies used Body Mass Index as a nutritional indicator for adults. For children, the height-for-age Z-score was most commonly used, while weight-for-age, weight-for-height and Body Mass Index-for-age were less commonly used. The national prevalence of double nutritional burden in households ranged from 1.71% to 38.7%, depending on the country and the year. However, direct comparisons between studies were limited due to differences in combinations of undernutrition, overweight or obesity. Among the factors associated with double nutritional burden within households, the most frequently cited in the selected articles were urban/rural residence, income or socioeconomic status, age of child and mother, household size and mother’s level of education. However, no study assessed physical activity, and very few examined the diet of household members. It is essential to take these different parameters into account when designing and implementing interventions to prevent the DBM in Africa. Community and societal factors will also need to be studied and taken into account in these interventions.
文摘Objective:This study aimed to have a good knowledge of heart failure complicated with malnutrition research status,hotspots,and forecast research trends using bibliometric analysis and visualization of studies of hear t failure complicated with malnutrition in the past 10 years.Methods:Ar ticles related to malnutrition-induced hear t failure were obtained from the Web of Science Core Collection(Wo SCC)series from January 2012 to January 2022.Two software(Java Cite Space 5.8R3 and Microsoft Excel 2019)were used to perform bibliometric and knowledge-map analysis,including analyzing the annual publication and trend of ar ticles,authors and co-cited authors,institutions/countries,co-cited journals,co-occurrence,clusters,and burst of keywords,co-cited references,and reference burst.Results:A total of 672 articles appeared in 180 scientific journals by 4249 authors from 1453 institutions in 71 countries.Over the past 10 years,the number of related studies released has shown an upward trend,and the range of increases has been larger over the past 5 years.Takatoshi Kasai released the most papers,while Anker S D had the most co-quotes.Simultaneously,active cooperation existed in complicated hear t failure with researchers on malnutrition.Circulation,Journal of The American College of Cardiology,and Clinical Nutrition were the top 3 co-cited journals.The USA,Japan,and China were the most productive countries,while Johns Hopkins University was the most active institution.In addition,the reference published by Ponikowski P had the most co-citations,relating to as a knowledge base.The latest hotspots of hear t failure complicated with malnutrition mainly included research on:(1)assessment of nutrition status,the impact/risk factor of nutrition,and the prevalence and outcome of the patients;(2)hear t failure complicated with malnutrition when complicated with other diseases,for example,chronic kidney disease and diabetes mellitus;(3)the nutrition of child patients with heart failure complicated with malnutrition;and(4)the treatment of heart failure complicated with malnutrition,including assist devices,organ transplantation,and drug therapy.While the frontier topics included research on:(1)the index of hear t failure complicated with malnutrition;(2)the effect of sarcopenia to hear t failure complicated with malnutrition patients and the use of geriatric nutritional risk index to assess the nutritional statue;and(3)find the nutritional risk index.Conclusions:This study conducted a full overview of the present research situation,hotspots,and frontiers by using bibliometric and visualization analysis methods in hear t failure complicated with malnutrition,which would provide a helpful reference for future research.
文摘Introduction: In Chad, malnutrition is a silent emergency. Yet the use of local products in the fight against malnutrition is essential. The purpose of this study was to compare the efficacy of locally sourced enriched flour in the recovery of children 6 to 59 months of moderate acute malnourishment compared to Ready-to-Use Therapeutic Foods (Plumpy’ Sup) in the city of Abéché-Chad. Methodology: This study took place from 1 October 2021 to 31 January 2022 in the city of Abéché, capital of the province of Ouaddaï. It was conducted in eight (8) urban health centers in the city of Abéché and concerned eighty (80) children with moderate acute malnutrition. It was based on a consumption assessment of two complementary foods by two groups of children. The assessment of nutritional status was made through anthropometric data such as weight, height and brachial perimeter. Results: All 80 children were tested for moderate acute malnutrition. Two complementary foods have been used which are locally produced flour and the Ready-to-Use Therapeutic Food. The study showed that the group 1 who consumed the locally produced flour had an average weight gain of 1100 g and the group 2 who consumed the Plumpy sup had an average weight gain of 400 g. Conclusion: The present study carried out in Abéché allowed us to compare the effectiveness of locally produced weaning flours with Ready-to-Use Therapeutic Foods on moderate malnourished child weight growth in the nutritional units of the town of Abéché.
文摘Introduction: Malnutrition is a public health problem. It is responsible for high morbidity and mortality in children aged 6 - 59 months. The aim of this study was to determine the outcome of children with complicated severe acute malnutrition after hospital discharge. Methods: This is a descriptive and analytical cross-sectional study conducted from March 1 to November 31, 2021 at the Albert Royer Children’s Hospital. Children discharged from hospital for complicated severe acute malnutrition were included. Results: A total of 103 children were included. The mean age of children at hospitalization was 16.41 ± 10.11 months and mean duration of follow-up after hospital discharge was 29.63 ± 8.59 months. Three children (2.91%) died after hospital discharge. The mean z-score of the weight-for-current height was -1.34 ± 1.08. Almost a quarter (24.27%) of the children remain acute malnourished with 3.88% of severe acute malnutrition (SAM). The predictors’ factors associated with non-response were weaning before 2 years of age (ORaj: 12.21;95% CI [6.82 - 18.44];p = 0.04) and tuberculosis (ORaj: 21.06;95% CI [12.54 - 41.09];p = 0.03). Conclusion: The rate of recovery of nutritional status in children with complicated severe acute malnutrition is satisfactory. Ablactation before the age of two and the existence of tuberculosis are significantly associated with non-recovery of nutritional status.
文摘Introduction: Severe acute malnutrition (SAM) is one of the main public health problems in the world. It is responsible in addition to the general symptoms, vitamin A deficiency which can cause serious eye damage including keratomalacia. This work aims to study possible ophthalmological lesions in severely acutely malnourished children from 0 to 60 months. Patients and Method: This study was carried out in a secondary ophthalmology center. It concerned all severely acute malnourished patients admitted for consultation in the pediatric department. Results: A total of 174 eyes of 87 children aged 0 to 60 months were examined. Two-thirds of the patients were aged between 6 and 18 months. Palpebral lesions are rare, however, we observed 12.64% blepharitis and palpebral dermatitis. Ocular involvement due to vitamin A deficiency was 6.9%, including one case of BITOT SPOT, 4 cases of conjunctival xerosis and one case of keratomalacia. Conclusion: Xerophthalmia is an ocular lesion due to a dietary intake deficient in vitamin A that occurs during severe acute malnutrition. Its occurrence is increasingly rare even in developing countries. However, some cases are observed in practice and may be responsible for profound visual impairments.
文摘Introduction: Severe acute malnutrition (SAM) is one of the main public health problems in the world. It is responsible in addition to the general symptoms, vitamin A deficiency which can cause serious eye damage including keratomalacia. This work aims to study possible ophthalmological lesions in severely acutely malnourished children from 0 to 60 months. Patients and Method: This study was carried out in a secondary ophthalmology center. It concerned all severely acute malnourished patients admitted for consultation in the pediatric department. Results: A total of 174 eyes of 87 children aged 0 to 60 months were examined. Two-thirds of the patients were aged between 6 and 18 months. Palpebral lesions are rare, however, we observed 12.64% blepharitis and palpebral dermatitis. Ocular involvement due to vitamin A deficiency was 6.9%, including one case of BITOT SPOT, 4 cases of conjunctival xerosis and one case of keratomalacia. Conclusion: Xerophthalmia is an ocular lesion due to a dietary intake deficient in vitamin A that occurs during severe acute malnutrition. Its occurrence is increasingly rare even in developing countries. However, some cases are observed in practice and may be responsible for profound visual impairments.
基金supported by the Spark Program from The First Hospital of Hebei Medical University(No.XH202316)the Innovation Funding Program for postgraduate students of Hebei Medical University(No.22034100684).
文摘Background:To examine the correlation between the dietary mineral intake and the nutritional status of patients suffering from malignan-cies.Methods:This multi-center cross-sectional study included a total of 866 patients with malignant tumors recruited from seven hospitals throughout China.The information of socio-demographic characteristics and biochemical indicators were obtained from electronic medical records of inpatients.Dietary data were collected using a 3-day 24-hour dietary recall questionnaire.The intake of energy,dietary calcium(Ca),phosphorus(P),potassium(K),sodium(Na),magnesium(Mg),iron(Fe),zinc(Zn),selenium(Se),copper(Cu)and manganese(Mn)were estimated according to the Chinese Food Composition Tables standard edition.The weight and height of patients were measured,and the body mass index(BMI)was calculated.Nutritional risk and malnutrition were assessed by the Nutritional Screening 2002(NRS 2002)and Global Leadership Initiative on Malnutrition(GLIM)diagnostic criteria.We used a multivariable logistic regression model to estimate the asso-ciations between dietary minerals and malnutrition.Results:The patients had an average age of 61.98(±15.49)years,and 40.6%(n=352)were female.Slightly less than half(44.5%)of the patients were at nutritional risk(NRS 2002≥3),and 32.7%were diagnosed with malnutrition(using the GUM criteria).Univariate analy-ses revealed that there was a statistically significant relationship between dietary mineral intake and the occurrence of nutritional risk(P<0.001).After adjusting the collinearity,we found that higher levels of P,Mn and Se intake were negatively associated with nutritional risk as-sessed by the NRS 2002 score.Moderate intake of Ca and high intake of Zn might also decrease the nutritional risk(Ca:OR,0.53,95%CI,0.32-0.88;Zn:OR,0.36,95%CI,0.19-0.68).However,no significant relationships were observed between any dietary mineral intake and malnutrition identified by the GUM criteria.Conclusions:Dietary minerals,especially P,Se,and Mn,may have a protective effect on the occurrence of nutritional risk in patients with malignant tumors.In addition,patients should maintain appropriate levels of Ca and Zn.
文摘Head and neck cancer and the approaches used to treat it can cause symptoms such as mucositis,alteration or loss of taste,dysphagia,and xerostomia,whichmakes the incidence of malnutrition in head and neck cancer patients higher than in the general population of cancer patients.Malnutrition in patients with head and neck cancer is associated with the occurrence of treatment-related adverse events,an increase in overall economic cost,a decline in quality of life,and a poor prognosis.Therefore,rehabilitation interventions for malnutrition are necessary throughout the course of the disease.However,the importance of rehabilitation interventions for malnutrition in patients with head and neck cancer has not been fully recognized,and the optimal methods and timing of interventions are unclear.This article provides an overview of rehabilitation interventions for malnutrition,including nutritional supplementation,exercise-based interventions,nutritional counseling and cognitive improvement,and drug therapy,and discusses their advantages and disadvantages as well as potential future directions.
文摘Primary biliary cholangitis(PBC)is a chronic cholestatic liver disease that is associated with impaired biliary excretion processes.Along with the development of cholestasis,there is a deficient flow of bile acids into the intestinal lumen causing malnutrition(MN)that is manifested in deficiencies of both macro-and micronutrients.The mechanism for development of trophological insufficiency is multifactorial.However,the trigger of MN in PBC is impaired enterohepatic circulation of bile acids.The ingress of bile acids with a detergent effect into the general bloodstream,followed by elimination via the kidneys and skin,triggers a cascade of metabolic disturbances,which leads to the gradual development and progression of calorie MN.The latter gradually transforms into protein-calorie MN(PСM)(as marasmus)due to the insufficient entry of bile acids into the duodenum,which is accompanied by a decrease in the emulsification,hydrolysis,and absorption of fats and fat-soluble vitamins,as well as disturbance of intestinal motility and bacterial overgrowth.Fat-soluble vitamin deficiencies complement PСM with vitamin and mineral MN.The development of hepatocellular failure enhances the progression of PСM due to the impaired protein synthetic function of hepatocytes in the advanced stage of PBC,which results in deficiency of not only the somatic but also the visceral pool of proteins.A mixed PСM form of marasmus and kwashiorkor develops.Early recognition of energy,protein,micronutrient,and macronutrient deficiencies is of great importance because timely nutritional support can improve liver function and quality of life in patients with PBC.In this case,it is important to know what type(energy,proteincalorie,vitamin,and vitamin-mineral)and form(marasmus,marasmuskwashiorkor)of MN is present in the patient and how it is associated with the stage of the disease.Therefore,it is recommended to screen all patients with PBC for MN,from the early asymptomatic stage of the disease in order to identify and avoid preventable complications,such as fatigue,malaise,performance decrement,sarcopenia,osteoporosis,and hepatic encephalopathy,which will be able to provide appropriate nutritional support for correction of the trophological status.
文摘Objective According to literature,cancer patients have the highest incidence of malnutrition among hospital patients(40%-80%).Despite this high prevalence,this condition is still under-diagnosed.The aim of this study was to conduct a systematic literature review and meta-analysis to assess the diagnostic performance of the Malnutrition Screening Tool(MST),a simple tool that can be applied in a busy setting where a comprehensive assessment at screening would be impractical.Methods PubMed,EMBASE and Cochrane central register of controlled trials were systematically searched to identify records relevant to the research question.The QUADAS-2 was used to assess the quality of each included study and the meta-analysis was conducted using the hierarchical bivariate model in STATA.Results Seven records were included in this study and the overall sensitivity specificity,diagnostic odds ratio(DOR).The pooled sensitivity and specificity generated after the meta-analysis in STATA were 0.78(95%CI:0.64-0.88)and 0.82(95%CI:0.76-0.87),respectively.The corresponding DOR was 16.33(95%CI:7.08-37.67).The positive likelihood ratio(LR+)was+4.39(95%CI:3.02-6.38),and the negative likelihood ratio(LR-)were 0.27(95%CI:0.16-0.47)and the 1/LR-3.72(2.14-6.46).Conclusion These results showed that the MST provides weak diagnostic evidence when used to screen for malnutrition in adult cancer patients.
基金Supported by The Bisa Research Grant of Keimyung University in 2006
文摘AIM: To evaluate the prevalence of preoperative and postoperative malnutrition and the relationships between objective and subjective nutritional assessment of gastric cancer patients. METHODS: From October 2005 to July 2006, we studied 80 patients with no evidence of recurrent disease and no loss to follow-up after curative surgery for gastric cancer. In this group, 9 patients underwent total gastrectomy and 71 patients subtotal gastrectomy. At admission, 6 and 12 mo after surgery, the patients were assessed on the subjective global assessment (SGA), nutritional risk screening (NRS-2002), nutritional risk index (NRI) and by anthropometric measurements and laboratory data. Differences between the independent groups were assessed with the Student's t test and oneway analysis of variance. Spearman's rank correlation coefficients were calculated to evaluate the association between the scores and variables. RESULTS: The prevalence of malnutrition at admissionwas 31% by SGA and 43% by NRS-2002. At admission, the anthropometric data were lower in the malnourished groups defined by the SGA and NRS-2002 assessments, but did not differ between the groups using the NRI assessment. Body weight (BW), body mass index (BMI), triceps skin fold and midarm circumference were significantly reduced, but the total lymphocyte count, albumin, protein, cholesterol and serum iron levels did not decrease during the postoperative period. Six months after surgery, there was a good correlation between the nutritional assessment tools (SGA and NRS-2002) and the other nutritional measurement tools (BW, BMI, and anthropometric measurements). However, 12 mo after surgery, most patients who were assessed as malnourished by SGA and NRS-2002 had returned to their preoperative status, although their BW, BMI, and anthropometric measurements still indicated a malnourished status. CONCLUSION: A combination of objective and subjective assessments is needed for the early detection of the nutritional status in case of gastric cancer patients after gastrectomy.
基金supported by National Health Commission(formerly National Health and Family Planning Commission)Medical Reform Major Program:China Nutrition and Health Surveillance[2010–2012]the secondary data analysis was sponsored by Nestle R&D center-National Institute for Nutrition and HealthChina CDC project-Research on Dietary and Nutritional Status of Chinese Elderly[No.150052]。
文摘Objective Nutrition is closely related to the health of the elderly population. This study aimed to provide a comprehensive picture of the nutrition status of elderly Chinese and its related dietary,geographical, and socioeconomic factors.Methods A total of 13,987 ≥ 60-year-old persons from the 2010–2013 Chinese National Nutrition and Health Survey were included to evaluate various aspects of malnutrition, including underweight,overweight or obesity, and micronutrient inadequacy.Results Overall, the prevalence of obesity, overweight, and underweight was 12.4%, 34.8%, and 5.7%,respectively, with disparities both geographically and socioeconomically. The prevalence of underweight was higher among the older old(≥ 75 years), rural residents and those with low income, with low education status, and residing in undeveloped West areas. More than 75% of the elderly do not meet the Dietary Reference Intakes for vitamins A, B1, B2, and E, folate, calcium, selenium, potassium, biotin,and choline, with the prevalence of inadequate intake increasing with age for most nutrients. At the population level, the mean intakes of numerous food groups did not meet the recommendations by the Chinese Dietary Guideline.Conclusions Obesity epidemic, inadequacy of micronutrient intake, and high prevalence of underweight and anemia in susceptible older people are the major nutrition challenges for the rapidly aging population in China.
文摘Malnutrition is highly prevalent in liver cirrhosis and its presence carries important prognostic implications.The clinical conditions and pathophysiological mechanisms that cause malnutrition in cirrhosis are multiple and interrelated.Anorexia and liver decompensation symptoms lead to poor dietary intake;metabolic changes characterised by elevated energy expenditure,reduced glycogen storage,an accelerated starvation response and protein catabolism result in muscle and fat wasting;and,malabsorption renders the cirrhotic patient unable to fully absorb or utilise food that has been consumed.Malnutrition is therefore a considerable challenge to manage effectively,particularly as liver disease progresses.A high energy,high protein diet is recognised as standard of care,yet patients struggle to follow this recommendation and there is limited evidence to guide malnutrition interventions in cirrhosis and liver transplantation.In this review,we seek to detail the factors which contribute to poor nutritional status in liver disease,and highlight complexities far greater than“poor appetite”or“reduced oral intake”leading to malnutrition.We also discuss management strategies to optimise nutritional status in this patient group,which target the inter-related mechanisms unique to advanced liver disease.Finally,future research requirements are suggested,to develop effective treatments for one of the most common and debilitating complications afflicting cirrhotic patients.
文摘Malnutrition is a highly prevalent and under recognized condition in developing countries of South Asia.The presence of malnutrition causes a severe impact on patients with liver cirrhosis.The etiology of cirrhosis differs in the South Asian region compared to the West,with hepatitis B and C still being the leading causes and the prevalence of nonalcoholic fatty liver disease increasing over time.Comorbid malnutrition worsens outcomes for cirrhosis patients.Urgent attention to address malnutrition is needed to improve patient outcomes.The etiology and pathophysiology of malnutrition in liver diseases is multifactorial,as reduction in liver function affects both macronutrients and micronutrients.A need for nutritional status assessment for liver disease patients exists in all parts of the world.There are many widely studied tools in use to perform a thorough nutritional assessment,of which some tools are low cost and do not require extensive training.These tools can be studied and evaluated for use in the resource limited setting of a country like Pakistan.Treatment guidelines for proper nutrition maintenance in chronic liver disease exist for all parts of the world,but the knowledge and practice of nutritional counseling in Pakistan is poor,both amongst patients and physicians.Emphasis on assessment for nutritional status at the initial visit with recording of vital signs is needed.Simultaneously,treating physicians need to be made aware of the misconceptions surrounding nutritional restrictions in cirrhosis so that patient education is done correctly based on proper scientific evidence.
文摘AIM: To investigate the prevalence of undernutrition, risk of malnutrition and obesity in the Italian gastroenterological population. METHODS: The Italian Hospital Gastroenterology Association conducted an observational, cross-sectional multicenter study. Weight, weight loss, and body mass index were evaluated. Undernutrition was defined as unintentional weight loss > 10% in the last threesix months. Values of Malnutrition Universal Screening Tool(MUST) > 2, NRS-2002 > 3, and Mini Nutritional Assessment(MNA) from 17 to 25 identified risk of malnutrition in outpatients, inpatients and elderly patients, respectively. A body mass index ≥ 30 indicated obesity. Gastrointestinal pathologies were categorized into acute, chronic and neoplastic diseases. RESULTS: A total of 513 patients participated in the study. The prevalence of undernutrition was 4.6% in outpatients and 19.6% in inpatients. Moreover, undernutrition was present in 4.3% of the gastrointestinal patients with chronic disease, 11.0% of those with acute disease, and 17.6% of those with cancer. The risk of malnutrition increased progressively and significantly in chronic, acute and neoplastic gastrointestinal diseases in inpatients and the elderly population. Logistical regression analysis confirmed that cancer was a risk factor for undernutrition(OR = 2.7; 95%CI: 1.2-6.44, P = 0.02). Obesity and overweight were more frequent in outpatients. CONCLUSION: More than 63% of outpatients and 80% of inpatients in gastroenterological centers suffered from significant changes in body composition and required specific nutritional competence and treatment.
文摘Background: Diabetes means the blood glucose, which is too high or too low. With Type 2 DM, the more common type, the body does not make or use insulin well. In patients with DM, Helicobacter pylori is one of the most common infections worldwide. Available data on the possible association between H. pylori infection and DM are contradictory. There are a few studies in the Middle East, and this study is the pioneer study, in the Medical Services Clinics in Gaza strip. Aims: This study was conducted to reveal the prevalence of H. pylori infection, malnutrition, insulin resistance among T2DM patients, to describe the dietary requirements of T2DM patients, finally to evaluate the current information about diet, and lifestyle in the prevention of H. pylori, and malnutrition. Methodology: A cross-sectional study was conducted in the Medical Services Clinics in Gaza Strip, and there were 129 patients included in this study. Data were collected through hematological information and structured interview questionnaire. Results: Highly significant percentage of H. pylori (70%) among the DM patients includes in the study, but not indicates any significant association between gender and H. pylori status. Conclusion: H. pylori patients should update their sugar level values in the record, and should get exercise and diet plan for every meal.
