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  1. Children successfully treated for moderate acute malnutrition remain at risk for malnutrition and death in the subsequent year after recovery

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Moderate acute malnutrition (MAM) affects 11% of children <5 y old worldwide and increases their risk for morbidity and mortality. It is assumed that successful treatment of MAM reduces these risks. A total of 1967 children aged 6-59 mo successfully treated for MAM in rural Malawi following randomiz...

  2. Extending supplementary feeding for children younger than 5 years with moderate acute malnutrition leads to lower relapse rates

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Children with moderate acute malnutrition (MAM) have a high rate of relapse and death in the year following recovery. In this pilot study, we evaluate the long-term benefits of an extended course of nutritional therapy for children with MAM. Rural Malawian children 6 to 59 months old with MAM, defin...

  3. Moderate acute malnutrition: uncovering the known and unknown for more effective prevention and treatment.

    PubMed

    Wegner, Christopher William; Loechl, Cornelia; Mokhtar, Najat

    2015-03-01

    With a fast-approaching post-Millennium Development Goal era, there is an urgent need to boost global investment in efforts to reduce child malnutrition. Critical to the management of moderate malnutrition, and therefore to the new Sustainable Development Goals, is addressing severe acute malnutrition (SAM) and moderate acute malnutrition (MAM). Despite the considerable difference in the approximate number of children affected by MAM (33 million) compared with SAM (19 million), there is currently no standardized approach to the management of MAM. In partnership with Valid International, the World Food Programme, and the Micronutrient Initiative, the International Atomic Energy Agency hosted the International Symposium on Understanding Moderate Malnutrition in Children for Effective Interventions in Vienna, Austria, 26-29 May 2014. This symposium focused on the management (prevention and treatment) of MAM in children. The symposium convened over 350 participants from 63 countries, the majority of whom represented governments responding to moderate malnutrition in their populations, nearly 70 national and international organizations from the United Nations and nongovernmental sectors, and universities from around the world, as well as donor governments and private-sector entities. The symposium was structured around nine sessions over a 3-day period, progressing from a global analysis of the scale of the problem to recent research findings relevant to designing effective interventions. This Supplement contains a series of papers that summarize the symposium sessions and other fundamental aspects important to improving the management of moderate malnutrition in children. PMID:25902608

  4. Severe acute malnutrition and infection

    PubMed Central

    Jones, Kelsey D J; Berkley, James A

    2014-01-01

    Severe acute malnutrition (SAM) is associated with increased severity of common infectious diseases, and death amongst children with SAM is almost always as a result of infection. The diagnosis and management of infection are often different in malnourished versus well-nourished children. The objectives of this brief are to outline the evidence underpinning important practical questions relating to the management of infectious diseases in children with SAM and to highlight research gaps. Overall, the evidence base for many aspects covered in this brief is very poor. The brief addresses antimicrobials; antipyretics; tuberculosis; HIV; malaria; pneumonia; diarrhoea; sepsis; measles; urinary tract infection; nosocomial Infections; soil transmitted helminths; skin infections and pharmacology in the context of SAM. The brief is structured into sets of clinical questions, which we hope will maximise the relevance to contemporary practice. PMID:25475887

  5. Stigma as a barrier to treatment for child acute malnutrition in Marsabit County, Kenya.

    PubMed

    Bliss, Jessica Robin; Njenga, Martin; Stoltzfus, Rebecca Joyce; Pelletier, David Louis

    2016-01-01

    Acute malnutrition affects millions of children each year, yet global coverage of life-saving treatment through the community-based management of acute malnutrition (CMAM) is estimated to be below 15%. We investigated the potential role of stigma as a barrier to accessing CMAM. We surveyed caregivers bringing children to rural health facilities in Marsabit County, Kenya, divided into three strata based on the mid-upper arm circumference of the child: normal status (n = 327), moderate acute malnutrition (MAM, n = 241) and severe acute malnutrition (SAM, n = 143). We used multilevel mixed effects logistic regression to estimate the odds of reporting shame as a barrier to accessing health care. We found that the most common barriers to accessing child health care were those known to be universally problematic: women's time and labour constraints. These constituted the top five most frequently reported barriers regardless of child acute malnutrition status. In contrast, the odds of reporting shame as a barrier were 3.64 (confidence interval: 1.66-8.03, P < 0.05) times higher in caregivers of MAM and SAM children relative to those of normal children. We conclude that stigma is an under-recognized barrier to accessing CMAM and may constrain programme coverage. In light of the large gap in coverage of CMAM, there is an urgent need to understand the sources of acute malnutrition-associated stigma and adopt effective means of de-stigmatization. PMID:25989353

  6. Ready-to-use foods for management of moderate acute malnutrition: Considerations for scaling up production and use in programs

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Ready-to-use foods are one of the available strategies for the treatment of moderate acute malnutrition (MAM), but challenges remain in the use of these products in programs at scale. This paper focuses on two challenges: the need for cheaper formulations using locally available ingredients that are...

  7. Antibiotics as part of the management of severe acute malnutrition

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Severe acute malnutrition contributes to 1 million deaths among children annually. Adding routine antibiotic agents to nutritional therapy may increase recovery rates and decrease mortality among children with severe acute malnutrition treated in the community. In this randomized, double-blind, plac...

  8. Management of acute moderate and severe childhood malnutrition

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Acute childhood malnutrition affects about a tenth of the world's children under 5 years of age, particularly those living in circumstances of extreme poverty in the developing world. Malnutrition is typically the result of an inadequate diet and is one of the most common diagnoses in children in he...

  9. Malnutrition

    MedlinePlus

    ... fats, vitamins, and minerals - you may suffer from malnutrition. Causes of malnutrition include: Lack of specific nutrients in your diet. ... the lack of one vitamin can lead to malnutrition. An unbalanced diet Certain medical problems, such as ...

  10. Malnutrition

    MedlinePlus

    ... you survive. Poverty, natural disasters, political problems, and war can all contribute to malnutrition and starvation, and ... Malnutrition is a significant problem all over the world, especially among children. It is very harmful to ...

  11. Psychosocial Care and its Association with Severe Acute Malnutrition.

    PubMed

    Singh, Anurag; Agarwal, Sheesham

    2016-05-01

    This cross-sectional study compared 120 children having severe acute malnutrition with 120 healthy children for exposure to 40 behaviors, by measuring psychosocial care based on Home Observation for Measurement of the Environment (HOME) inventory. The mean (SD) psychosocial care score of cases and controls significantly differed [18.2 (2.2) vs 23.5 (2.1); P<0.001]. A score of less than 14 was significantly associated with severe acute malnutrition (OR 23.2; 95% CI 8.2, 50). PMID:27254059

  12. Including whey protein and whey permeate in ready-to-use supplementary food improves recovery rates in children with moderate acute malnutrition: A randomized, double-blind clinical trial

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The utility of dairy ingredients in the supplementary foods used in the treatment of childhood moderate acute malnutrition (MAM) remains unsettled. We evaluated the effectiveness of a peanut-based ready-to-use supplementary food (RUSF) with soy protein compared with a novel RUSF containing dairy in...

  13. A novel fortified blended flour, corn-soy blend "plus-plus," is not inferior to lipid-based ready-to-use supplementary foods for the treatment of moderate acute malnutrition in Malawian children

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Children with moderate acute malnutrition (MAM) are often treated with fortified blended flours, most commonly a corn-soy blend (CSB). However, recovery rates remain <75%, lower than the rate achieved with peanut-paste-based ready-to-use supplementary foods (RUSFs). To bridge this gap, a novel CSB r...

  14. Management of acute malnutrition in infants aged under 6 months (MAMI): Current issues and future directions in policy and research

    PubMed Central

    Kerac, Marko; Mwangome, Martha; McGrath, Marie; Haider, Rukhsana; Berkley, James A.

    2016-01-01

    Background Globally, some 4.7 million infants aged under 6 months are moderately wasted and 3.8 million are severely wasted. Traditionally, they have been overlooked by clinicians, nutritionists, and policy makers. Objective To present evidence and arguments for why treating acute malnutrition in infants under 6 months of age is important and outline some of the key debates and research questions needed to advance their care. Methods Narrative review. Results and conclusions Treating malnourished infants under 6 months of age is important to avoid malnutrition-associated mortality in the short term and adverse health and development outcomes in the long term. Physiological and pathological differences demand a different approach from that in older children; key among these is a focus on exclusive breastfeeding wherever possible. New World Health Organization guidelines for the management of severe acute malnutrition (SAM) include this age group for the first time and are also applicable to management of moderate acute malnutrition (MAM). Community-based breastfeeding support is the core, but not the sole, treatment. The mother–infant dyad is at the heart of approaches, but wider family and community relationships are also important. An urgent priority is to develop better case definitions; criteria based on mid-upper-arm circumference (MUAC) are promising but need further research. To effectively move forward, clinical trials of assessment and treatment are needed to bolster the currently sparse evidence base. In the meantime, nutrition surveys and screening at health facilities should routinely include infants under 6 months of age in order to better define the burden and outcomes of acute malnutrition in this age group. PMID:25993754

  15. Severe acute malnutrition during emergencies: burden management, and gaps.

    PubMed

    Bahwere, Paluku

    2014-06-01

    Natural and man-made disasters, including floods, droughts, earthquakes, and armed conflicts, create nutrition crises. Unfortunately, the frequency and severity of such disasters have been increasing since the beginning of the 20th century, and their contribution to the burden of acute malnutrition is increasing every year. However, their contribution to the burden of acute malnutrition is underrecognized due to the ways in which global statistics are built and causes of death are reported. Fortunately, the success of the current protocol for treatment of severe acute malnutrition (SAM) and the integrated approach to treatment has created a momentum allowing expanded coverage of treatment of SAM, especially in humanitarian emergency contexts. For this progress to be maintained and accelerated, changes in nutrition information systems at the national and global levels are needed, and the persisting barriers to the expansion and integration of treatment of SAM into routine health systems need to be removed. Emergency funding approaches and objectives have to include sustaining and amplifying the achievements of the short-term palliative interventions. Nutrition programs implemented in emergency contexts have the capacity to contribute to answering priority research questions, and this capacity should be more optimally utilized. PMID:25069293

  16. Treatment of severe and moderate acute malnutrition in low- and middle-income settings: a systematic review, meta-analysis and Delphi process

    PubMed Central

    2013-01-01

    Background Globally, moderate acute malnutrition (MAM) and severe acute malnutrition (SAM) affect approximately 52 million children under five. This systematic review evaluates the effectiveness of interventions for SAM including the World Health Organization (WHO) protocol for inpatient management and community-based management with ready-to-use-therapeutic food (RUTF), as well as interventions for MAM in children under five years in low- and middle-income countries. Methods We systematically searched the literature and included 14 studies in the meta-analysis. Study quality was assessed using CHERG adaptation of GRADE criteria. A Delphi process was undertaken to complement the systematic review in estimating case fatality and recovery rates that were necessary for modelling in the Lives Saved Tool (LiST). Results Case fatality rates for inpatient treatment of SAM using the WHO protocol ranged from 3.4% to 35%. For community-based treatment of SAM, children given RUTF were 51% more likely to achieve nutritional recovery than the standard care group. For the treatment of MAM, children in the RUSF group were significantly more likely to recover and less likely to be non-responders than in the CSB group. In both meta-analyses, weight gain in the intervention group was higher, and although statistically significant, these differences were small. Overall limitations in our analysis include considerable heterogeneity in many outcomes and an inability to evaluate intervention effects separate from commodity effect. The Delphi process indicated that adherence to standardized protocols for the treatment of SAM and MAM should have a marked positive impact on mortality and recovery rates; yet, true consensus was not achieved. Conclusions Gaps in our ability to estimate effectiveness of overall treatment approaches for SAM and MAM persist. In addition to further impact studies conducted in a wider range of settings, more high quality program evaluations need to be conducted

  17. Integration of HIV Care into Community Management of Acute Childhood Malnutrition Permits Good Outcomes: Retrospective Analysis of Three Years of a Programme in Lusaka

    PubMed Central

    Amadi, Beatrice; Imikendu, Mercy; Sakala, Milika; Banda, Rosemary; Kelly, Paul

    2016-01-01

    Background While HIV has had a major impact on health care in southern Africa, there are few data on its impact on acute malnutrition in children in the community. We report an analysis of outcomes in a large programme of community management of acute malnutrition in the south of Lusaka. Programme Activities and Analysis Over 3 years, 68,707 assessments for undernutrition were conducted house-to-house, and children with severe acute malnutrition (SAM) or moderate acute malnutrition (MAM) were enrolled into either Outpatient Therapeutic Programme (OTP) or Supplementary Feeding Programme (SFP) respectively. Case records were analysed using tabulation and unconditional logistic regression. Findings 1,859 children (889 boys, 970 girls; median age 16 months) with MAM (n = 664) or SAM (n = 1,195) were identified. Of 1,796 children whose parents consented to testing, 185 (10.3%) were HIV positive. Altogether 1,163 (62.6%) were discharged as recovered from acute malnutrition. Case fatality while in the programme was 4.2% in children with SAM and 0.5% in those with MAM (RR of SAM 10.9; 95%CI 3.4,34.8; P<0.0001), and higher in children with HIV infection (RR 5.2, 95%CI 2.9, 9.0; P<0.0001). In multivariate analysis, HIV (OR 5.2; 95%CI 2.6, 10.1; P<0.0001), MUAC <11.5cm (OR 4.1; 95%CI 2.2, 7.4; P<0.0001) and the first year of the programme (OR 1.9; 95%CI 1.0, 3.4; P = 0.04) all increased mortality. Children with HIV infection who were able to initiate antiretroviral therapy had lower mortality (RR 0.23; 95%CI 0.10, 0.57; P = 0.0008). Interpretation Our programme suggests that a comprehensive community malnutrition programme, incorporating HIV care, can achieve low mortality even in a population heavily affected by HIV. PMID:26943124

  18. Home-based therapy for severe acute malnutrition with ready-to-use food

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Severe acute malnutrition is a devastating condition afflicting children under 5 years in many developing countries, but concentrated in sub-Saharan Africa. This paper examines the development of home-based lipid-nutrient therapeutic foods for the treatment of acute malnutrition in sub-Saharan Afric...

  19. Preventing Acute Malnutrition among Young Children in Crises: A Prospective Intervention Study in Niger

    PubMed Central

    Langendorf, Céline; Roederer, Thomas; de Pee, Saskia; Brown, Denise; Doyon, Stéphane; Mamaty, Abdoul-Aziz; Touré, Lynda W.-M.; Manzo, Mahamane L.; Grais, Rebecca F.

    2014-01-01

    Background Finding the most appropriate strategy for the prevention of moderate acute malnutrition (MAM) and severe acute malnutrition (SAM) in young children is essential in countries like Niger with annual “hunger gaps.” Options for large-scale prevention include distribution of supplementary foods, such as fortified-blended foods or lipid-based nutrient supplements (LNSs) with or without household support (cash or food transfer). To date, there has been no direct controlled comparison between these strategies leading to debate concerning their effectiveness. We compared the effectiveness of seven preventive strategies—including distribution of nutritious supplementary foods, with or without additional household support (family food ration or cash transfer), and cash transfer only—on the incidence of SAM and MAM among children aged 6–23 months over a 5-month period, partly overlapping the hunger gap, in Maradi region, Niger. We hypothesized that distributions of supplementary foods would more effectively reduce the incidence of acute malnutrition than distributions of household support by cash transfer. Methods and Findings We conducted a prospective intervention study in 48 rural villages located within 15 km of a health center supported by Forum Santé Niger (FORSANI)/Médecins Sans Frontières in Madarounfa. Seven groups of villages (five to 11 villages) were allocated to different strategies of monthly distributions targeting households including at least one child measuring 60 cm–80 cm (at any time during the study period whatever their nutritional status): three groups received high-quantity LNS (HQ-LNS) or medium-quantity LNS (MQ-LNS) or Super Cereal Plus (SC+) with cash (€38/month [US$52/month]); one group received SC+ and family food ration; two groups received HQ-LNS or SC+ only; one group received cash only (€43/month [US$59/month]). Children 60 cm–80 cm of participating households were assessed at each monthly distribution from

  20. Ready-to-use foods for management of moderate acute malnutrition: considerations for scaling up production and use in programs.

    PubMed

    Osendarp, Saskia; Rogers, Beatrice; Ryan, Kelsey; Manary, Mark; Akomo, Peter; Bahwere, Paluku; Belete, Hilina; Zeilani, Mamane; Islam, Munirul; Dibari, Filippo; De Pee, Saskia

    2015-03-01

    Ready-to-use foods are one of the available strategies for the treatment of moderate acute malnutrition (MAM), but challenges remain in the use of these products in programs at scale. This paper focuses on two challenges: the need for cheaper formulations using locally available ingredients that are processed in a safe, reliable, and financially sustainable local production facility; and the effective use of these products in large-scale community-based programs. Linear programming tools can be used successfully to design local compositions that are in line with international guidelines, low in cost, and acceptable, and the efficacy of these local formulations in the treatment of MAM was recently demonstrated in Malawi. The production of local formulations for programs at scale relies on the existence of a reliable and efficient local production facility. Technical assistance may be required in the development of sustainable business models at an early stage in the process, taking into account the stringent product quality and safety criteria and the required investments. The use of ready-to-use products, as of any food supplement, in programs at scale will be affected by the practice of household sharing and diversion of these products for other uses. Additional measures can be considered to account for sharing. These products designed for the treatment and prevention of MAM are to be used in community-based programs and should therefore be used in conjunction with other interventions and designed so that they do not replace the intake of other foods and breastmilk. Remaining challenges and implications for the (operations) research agenda are discussed. PMID:25902616

  1. Children with Moderate Acute Malnutrition with No Access to Supplementary Feeding Programmes Experience High Rates of Deterioration and No Improvement: Results from a Prospective Cohort Study in Rural Ethiopia

    PubMed Central

    James, Philip; Sadler, Kate; Wondafrash, Mekitie; Argaw, Alemayehu; Luo, Hanqi; Geleta, Benti; Kedir, Kiya; Getnet, Yilak; Belachew, Tefera; Bahwere, Paluku

    2016-01-01

    Background Children with moderate acute malnutrition (MAM) have an increased risk of mortality, infections and impaired physical and cognitive development compared to well-nourished children. In parts of Ethiopia not considered chronically food insecure there are no supplementary feeding programmes (SFPs) for treating MAM. The short-term outcomes of children who have MAM in such areas are not currently described, and there remains an urgent need for evidence-based policy recommendations. Methods We defined MAM as mid-upper arm circumference (MUAC) of ≥11.0cm and <12.5cm with no bilateral pitting oedema to include Ethiopian government and World Health Organisation cut-offs. We prospectively surveyed 884 children aged 6–59 months living with MAM in a rural area of Ethiopia not eligible for a supplementary feeding programme. Weekly home visits were made for seven months (28 weeks), covering the end of peak malnutrition through to the post-harvest period (the most food secure window), collecting anthropometric, socio-demographic and food security data. Results By the end of the study follow up, 32.5% (287/884) remained with MAM, 9.3% (82/884) experienced at least one episode of SAM (MUAC <11cm and/or bilateral pitting oedema), and 0.9% (8/884) died. Only 54.2% of the children recovered with no episode of SAM by the end of the study. Of those who developed SAM half still had MAM at the end of the follow up period. The median (interquartile range) time to recovery was 9 (4–15) weeks. Children with the lowest MUAC at enrolment had a significantly higher risk of remaining with MAM and a lower chance of recovering. Conclusions Children with MAM during the post-harvest season in an area not eligible for SFP experience an extremely high incidence of SAM and a low recovery rate. Not having a targeted nutrition-specific intervention to address MAM in this context places children with MAM at excessive risk of adverse outcomes. Further preventive and curative approaches

  2. Impaired Bile Acid Homeostasis in Children with Severe Acute Malnutrition

    PubMed Central

    Zhang, Ling; Voskuijl, Wieger; Mouzaki, Marialena; Groen, Albert K.; Alexander, Jennifer; Bourdon, Celine; Wang, Alice; Versloot, Christian J.; Di Giovanni, Valeria; Wanders, Ronald J. A.; Bandsma, Robert

    2016-01-01

    Objective Severe acute malnutrition (SAM) is a major cause of mortality in children under 5 years and is associated with hepatic steatosis. Bile acids are synthesized in the liver and participate in dietary fat digestion, regulation of energy expenditure, and immune responses. The aim of this work was to investigate whether SAM is associated with clinically relevant changes in bile acid homeostasis. Design An initial discovery cohort with 5 healthy controls and 22 SAM-patients was used to identify altered bile acid homeostasis. A follow up cohort of 40 SAM-patients were then studied on admission and 3 days after clinical stabilization to assess recovery in bile acid metabolism. Recruited children were 6–60 months old and admitted for SAM in Malawi. Clinical characteristics, feces and blood were collected on admission and prior to discharge. Bile acids, 7α-hydroxy-4-cholesten-3-one (C4) and FGF-19 were quantified. Results On admission, total serum bile acids were higher in children with SAM than in healthy controls and glycine-conjugates accounted for most of this accumulation with median and interquartile range (IQR) of 24.6 μmol/L [8.6–47.7] compared to 1.9 μmol/L [1.7–3.3] (p = 0.01) in controls. Total serum bile acid concentrations did not decrease prior to discharge. On admission, fecal conjugated bile acids were lower and secondary bile acids higher at admission compared to pre- discharge, suggesting increased bacterial conversion. FGF19 (Fibroblast growth factor 19), a marker of intestinal bile acid signaling, was higher on admission and was associated with decreased C4 concentrations as a marker of bile acid synthesis. Upon recovery, fecal calprotectin, a marker of intestinal inflammation, was lower. Conclusion SAM is associated with increased serum bile acid levels despite reduced synthesis rates. In SAM, there tends to be increased deconjugation of bile acids and conversion from primary to secondary bile acids, which may contribute to the

  3. A Study of Oxidative Stress Biomarkers and Effect of Oral Antioxidant Supplementation in Severe Acute Malnutrition

    PubMed Central

    Ghone, Rahul A.; Suryakar, Adinath N.; Kulhalli, P. M.; Bhagat, Sonali S.; Padalkar, Ramchandra K.; Karnik, Aarti C.; Hundekar, Prakash S.; Sangle, D. A.

    2013-01-01

    Background: Malnutrition represents one of the most severe health problems in India. Free radicals play an important role in immunological response, which induces the oxidative surplus in severe acute malnutrition. Severe dietary deficiency of nutrients leads to increased oxidative stress in cellular compartments. Aim: The goal of this study was to inspect impact of oxidative stress in the form of serum malondialdehyde as product of lipid peroxidation, vitamin E, zinc and erythrocyte superoxide dismutase in patients with severe acute malnutrition. Material and Methods: Sixty severe acute malnutrition patients were studied before and after supplementation of antioxidants for one month, and their status were compared with those of 60 age and sex matched healthy controls. The level of serum MDA was analyzed by the Kei Satoh method, serum vitamin E concentration was measured by Baker and Frank Method, serum zinc was measured by using Atomic Absorption Spectrophotometer (AAS) and erythrocyte superoxide dismutase was measured by Kajari Das Method. Results: Significantly increased levels of serum malondialdehyde (p<0.001) were found in the patients as compared to those in controls, and significant depletions were found in the levels of serum vitamin E, zinc and erythrocyte superoxide dismutase in patients with severe acute malnutrition as compared to those in controls. After supplementation of antioxidants for one month, the levels of malondialdehyde were found to be decreased significantly (p<0.001) and zinc and erythrocyte superoxide dismutase capacity levels were increased significantly (p<0.05). Also, there was a non–significant (p>0.05) increase in vitamin E levels as compared to those before supplementation results. Conclusion: Harsh deficiency of various nutrients in severe acute malnutrition leads to generation of heavy oxidative stress. These effects may be minimized with supplementation of antioxidants. PMID:24298460

  4. Program Responses to Acute and Chronic Malnutrition: Divergences and Convergences123

    PubMed Central

    Bergeron, Gilles; Castleman, Tony

    2012-01-01

    Program approaches for addressing acute malnutrition and those for addressing chronic malnutrition have grown in different directions. Their specialization has led to productive advances in the efficacy of specific interventions but has also created divergences in implementation. Greater convergence and integration between the 2 sets of approaches would help programs respond to the diversity of conditions faced in the field and enable a more comprehensive continuum of care from prevention to treatment. After reviewing the causes of the differences in approach, this paper examines programmatic and scientific challenges to greater convergence and suggests steps to promote effective integration of acute and chronic malnutrition services. Steps include strengthening community linkages between program platforms, assessing the degree and type of integration needed in various situations, identifying cost efficiencies, and developing joint tools where possible. PMID:22516735

  5. Gut DNA viromes of Malawian twins discordant for severe acute malnutrition

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The bacterial component of the human gut microbiota undergoes a definable program of postnatal development. Evidence is accumulating that this program is disrupted in children with severe acute malnutrition (SAM) and that their persistent gut microbiota immaturity, which is not durably repaired with...

  6. Management of severe acute malnutrition in low-income and middle-income countries

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Kwashiorkor and marasmus, collectively termed severe acute malnutrition (SAM), account for at least 10% of all deaths among children under 5 years of age worldwide, virtually all of them in low-income and middle-income countries. A number of risk factors, including seasonal food insecurity, environm...

  7. Gut Microbiota in Children Hospitalized with Oedematous and Non-Oedematous Severe Acute Malnutrition in Uganda

    PubMed Central

    Kristensen, Kia Hee Schultz; Wiese, Maria; Rytter, Maren Johanne Heilskov; Özçam, Mustafa; Hansen, Lars Hestbjerg; Namusoke, Hanifa; Friis, Henrik; Nielsen, Dennis Sandris

    2016-01-01

    Background Severe acute malnutrition (SAM) among children remains a major health problem in many developing countries. SAM manifests in both an oedematous and a non-oedematous form, with oedematous malnutrition in its most severe form also known as kwashiorkor. The pathogenesis of both types of malnutrition in children remains largely unknown, but gut microbiota (GM) dysbiosis has recently been linked to oedematous malnutrition. In the present study we aimed to assess whether GM composition differed between Ugandan children suffering from either oedematous or non-oedematous malnutrition. Methodology/Principal Findings As part of an observational study among children hospitalized with SAM aged 6–24 months in Uganda, fecal samples were collected at admission. Total genomic DNA was extracted from fecal samples, and PCR amplification was performed followed by Denaturing Gradient Gel Electrophoresis (DGGE) and tag-encoded 16S rRNA gene-targeted high throughput amplicon sequencing. Alpha and beta diversity measures were determined along with ANOVA mean relative abundance and G-test of independence followed by comparisons between groups. Of the 87 SAM children included, 62% suffered from oedematous malnutrition, 66% were boys and the mean age was 16.1 months. GM composition was found to differ between the two groups of children as determined by DGGE (p = 0.0317) and by high-throughput sequencing, with non-oedematous children having lower GM alpha diversity (p = 0.036). However, beta diversity analysis did not reveal larger differences between the GM of children with oedematous and non-oedematous SAM (ANOSIM analysis, weighted UniFrac, R = -0.0085, p = 0.584; unweighted UniFrac, R = 0.0719, p = 0.011). Conclusions/Significance Our results indicate that non-oedematous SAM children have lower GM diversity compared to oedematous SAM children, however no clear compositional differences were identified. PMID:26771456

  8. Factors Associated with Acute Malnutrition among Children Admitted to a Diarrhoea Treatment Facility in Bangladesh

    PubMed Central

    Fuchs, Connor; Sultana, Tania; Ahmed, Tahmeed; Iqbal Hossain, M.

    2014-01-01

    To assess the risk factors for acute malnutrition (weight-for-height z-score (WHZ) < −2), a case-control study was conducted during June–September 2012 in 449 children aged 6–59 months (178 with WHZ < −2 and 271 comparing children with WHZ ≥ −2 and no edema) admitted to the Dhaka Hospital of icddr,b in Bangladesh. The overall mean ± SD age was 12.0 ± 7.6 months, 38.5% (no difference between case and controls). The mean ± SD WHZ of cases and controls was −3.24 ± 1.01 versus −0.74 ± 0.95 (P < 0.001), respectively. Logistic regression analysis revealed that children with acute malnutrition were more likely than controls to be older (age > 1 year) (adjusted OR (AOR): 3.1, P = 0.004); have an undernourished mother (body mass index < 18.5), (AOR: 2.8, P = 0.017); have a father with no or a low-paying job (AOR: 5.8, P < 0.001); come from a family having a monthly income of <10,000 taka, (1 US$ = 80 taka) (AOR: 2.9, P = 0.008); and often have stopped predominant breastfeeding before 4 months of age (AOR: 2.7, P = 0.013). Improved understanding of these characteristics enables the design and targeting of preventive-intervention programs of childhood acute malnutrition. PMID:24734048

  9. Acute malnutrition among under-five children in Faryab, Afghanistan: prevalence and causes

    PubMed Central

    Frozanfar, Muhammad Kamel; Yoshida, Yoshitoku; Yamamoto, Eiko; Reyer, Joshua A.; Dalil, Suraya; Rahimzad, Abdullah Darman; Hamajima, Nobuyuki

    2016-01-01

    ABSTRACT Acute malnutrition affects more than 50 million under-five (U5) children, causing 8.0% of global child deaths annually. The prevalence of acute malnutrition (wasting) among U5 children in Afghanistan was 9.5% nationally and 3.7% in Faryab province in 2013. A cross-sectional study was conducted for 600 households in Faryab to find the prevalence and causes of acute malnutrition. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using a logistic model. Demographic results of this study showed that 54.0% of the household heads and 92.3% of the mothers had no education. Three-fourths of households had a monthly income ≤ 250 USD. According to the measurement of weight for height Z-score (WHZ), 35.0% (210/600) of the children had acute malnutrition (wasting, WHZ < −2). In more than half of the households, water, sanitation, and hygiene (WASH) conditions were poor. When adjusted, a significant association of acute malnutrition among U5 children was found with the education level of household heads (OR=1.49; 95% CI, 1.02–2.17), age of household heads (OR=2.01; 95% CI, 1.21–3.35), income (OR=1.66; 95% CI, 1.04–2.27), education level of mothers (OR=2.21; 95% CI, 1.00–4.88), age of children (OR=1.99; 95% CI, 1.32–2.93), history of children with diarrhea in the last two weeks of data collection (OR=1.57; 95% CI, 1.10–2.27), feeding frequency (OR=3.01; 95% CI, 1.21–7.46), water sources (OR=1.89; 95% CI, 1.26–2.83), and iodized salt (OR=0.59; 95% CI, 0.39–0.88). The present study indicated that an increase in education level of parents, household income, and quality of WASH would result in a significant decrease in prevalence of wasting among U5 children. PMID:27019527

  10. Effectiveness of ready-to-use therapeutic food compared to a corn/soy-blend-based pre-mix for the treatment of childhood moderate acute malnutrition in Niger.

    PubMed

    Nackers, Fabienne; Broillet, France; Oumarou, Diakité; Djibo, Ali; Gaboulaud, Valérie; Guerin, Philippe J; Rusch, Barbara; Grais, Rebecca F; Captier, Valérie

    2010-12-01

    Standard nutritional treatment of moderate acute malnutrition (MAM) relies on fortified blended flours though their importance to treat this condition is a matter of discussion. With the newly introduced World Health Organization growth standards, more children at an early stage of malnutrition will be treated following the dietary protocols as for severe acute malnutrition, including ready-to-use therapeutic food (RUTF). We compared the effectiveness of RUTF and a corn/soy-blend (CSB)-based pre-mix for the treatment of MAM in the supplementary feeding programmes (SFPs) supported by Médecins Sans Frontières, located in the Zinder region (south of Niger). Children measuring 65 to <110 cm, newly admitted with MAM [weight-for-height (WHM%) between 70% and <80% of the NCHS median] were randomly allocated to receive either RUTF (Plumpy'Nut®, 1000 kcal day(-1)) or a CSB pre-mix (1231 kcal day(-1)). Other interventions were similar in both groups (e.g. weekly family ration and ration at discharge). Children were followed weekly up to recovery (WHM% ≥ 85% for 2 consecutive weeks). In total, 215 children were recruited in the RUTF group and 236 children in the CSB pre-mix group with an overall recovery rate of 79.1 and 64.4%, respectively (p < 0.001). There was no evidence for a difference between death, defaulter and non-responder rates. More transfers to the inpatient Therapeutic Feeding Centre (I-TFC) were observed in the CSB pre-mix group (19.1%) compared to the RUTF group (9.3%) (p = 0.003). The average weight gain up to discharge was 1.08 g kg(-1) day(-1) higher in the RUTF group [95% confidence interval: 0.46-1.70] and the length of stay was 2 weeks shorter in the RUTF group (p < 0.001). For the treatment of childhood MAM in Niger, RUTF resulted in a higher weight gain, a higher recovery rate, a shorter length of stay and a lower transfer rate to the I-TFC compared to a CSB pre-mix. This might have important implications on the efficacy and the quality of SFPs

  11. Evaluation of the acceptability of improved supplementary foods for the treatment of moderate acute malnutrition in Burkina Faso using a mixed method approach.

    PubMed

    Iuel-Brockdorf, Ann-Sophie; Draebel, Tania Aase; Ritz, Christian; Fabiansen, Christian; Cichon, Bernardette; Brix Christensen, Vibeke; Yameogo, Charles; Oummani, Rouafi; Briend, André; Michaelsen, Kim F; Ashorn, Per; Filteau, Suzanne; Friis, Henrik

    2016-04-01

    The objective of this study was to evaluate, within the context of a randomized controlled trial of product effectiveness, the acceptability of new formulations of six corn-soy blended flours (CSB) and six lipid-based nutrient supplements (LNS) with different quantities of milk and qualities of soy for the treatment of children with moderate acute malnutrition (MAM). Our study included 1546 children aged 6-23 months and involved questionnaires after one month of supplementation home visits and interviews with a sub-sample of 20 trial participants and their caretakers, and nine focus group discussion. All 12 products were well accepted in terms of organoleptic qualities and received good ratings. However, LNS were more appreciated by caretakers and children. Additionally, an effect of soy isolate was detected on child appreciation where products with high milk content also received better ratings. CSB were not consumed as readily; 33.9% (n = 257) of children receiving CSB were reported to have leftovers compared to 17.3% (n = 134) of children receiving LNS (p=<0.001). Both CSB and LNS were referred to as foods with medicinal properties and perceived as beneficial to child health. They were both reported to have high priority in the daily feeding of the child. In conclusion, there were minimal differences in acceptability of the various CSB and LNS formulations, although CSB were less readily consumed and required smaller meal volumes. Since all products were well-accepted, decisions regarding whether the more expensive products should be used for the treatment of MAM will need to be based on their effect on child nutrition, growth and health. Future supplementary feeding programs in similar contexts could furthermore consider introducing supplementary foods as a medical treatment, as this may increase adherence and decrease sharing. PMID:26752599

  12. Malnutrition and inflammation in acute kidney injury due to earthquake-related crush syndrome

    PubMed Central

    2010-01-01

    Background Malnutrition and inflammation are common and serious complications in patients with acute kidney injury (AKI). However, the profile of these complications in patients with AKI caused by crush syndrome (CS) remains unclear. This study describes the clinical characteristics of malnutrition and inflammation in patients with AKI and CS due to the Wenchuan earthquake. Methods One thousand and twelve victims and eighteen healthy adults were recruited to the study. They were divided into five groups: Group A was composed of victims without CS and AKI (904 cases); Group B was composed of patients with CS and AKI who haven't received renal replacement therapy (RRT) (57 cases); and Group C was composed of patients with CS and AKI receiving RRT (25 cases); Group D was composed of earthquake victims with AKI but without CS (26 cases); and Group E was composed of 18 healthy adult controls. The C-reactive protein (CRP), prealbumin, transferrin, interleukin-6 and TNF-α were measured and compared between Group E and 18 patients from Group C. Results The results indicate that participants in Group C had the highest level of serum creatinine, blood urea nitrogen and uric acid. Approximately 92% of patients with CS who had RRT were suffering from hypoalbuminemia. The interleukin-6 and CRP levels were significantly higher in patients with CS AKI receiving RRT than in the control group. Patients in Group C received the highest dosages of albumin, plasma or red blood cell transfusions. One patient in Group C died during treatment. Conclusions Malnutrition and inflammation was common in patients with earthquake-related CS and had a negative impact on the prognosis of these subjects. The results of this study indicate that the use of RRT, intensive nutritional supplementation and transfusion alleviated the degree of malnutrition and inflammation in hemodialysis patients with crush syndrome. PMID:20346168

  13. A novel fortified blended flour, corn-soy blend “plus-plus,” is not inferior to lipid-based ready-to-use supplementary foods for the treatment of moderate acute malnutrition in Malawian children12345

    PubMed Central

    LaGrone, Lacey N; Trehan, Indi; Meuli, Gus J; Wang, Richard J; Thakwalakwa, Chrissie; Maleta, Kenneth; Manary, Mark J

    2012-01-01

    Background: Children with moderate acute malnutrition (MAM) are often treated with fortified blended flours, most commonly a corn-soy blend (CSB). However, recovery rates remain <75%, lower than the rate achieved with peanut paste–based ready-to-use supplementary foods (RUSFs). To bridge this gap, a novel CSB recipe fortified with oil and dry skim milk, “CSB++,” has been developed. Objective: In this trial we compared CSB++ with 2 RUSF products for the treatment of MAM to test the hypothesis that the recovery rate achieved with CSB++ will not be >5% worse than that achieved with either RUSF. Design: We conducted a prospective, randomized, investigator-blinded, controlled noninferiority trial involving rural Malawian children aged 6–59 mo with MAM. Children received 75 kcal CSB++ · kg−1 · d−1, locally produced soy RUSF, or an imported soy/whey RUSF for ≤12 wk. Results: The recovery rate for CSB++ (n = 763 of 888; 85.9%) was similar to that for soy RUSF (795 of 806, 87.7%; risk difference: −1.82%; 95% CI: −4.95%, 1.30%) and soy/whey RUSF (807 of 918, 87.9%; risk difference: −1.99%; 95% CI: −5.10%, 1.13%). On average, children who received CSB++ required 2 d longer to recover, and the rate of weight gain was less than that with either RUSF, although height gain was the same among all 3 foods studied. Conclusions: A novel, locally produced, fortified blended flour (CSB++) was not inferior to a locally produced soy RUSF and an imported soy/whey RUSF in facilitating recovery from MAM. The recovery rate observed for CSB++ was higher than that for any other fortified blended flour tested previously. This trial is registered at clinicaltrials.gov as NCT00998517. PMID:22170366

  14. Malnutrition and anaemia among hospitalised children in Vavuniya.

    PubMed

    Keerthiwansa, J; Gajealan, S; Sivaraja, S; Subashini, K Y

    2014-12-01

    We conducted a cross sectional descriptive study to describe the factors associated with the degree of malnutrition among hospitalised malnourished children in General Hospital, Vavuniya. All hospitalised children from January to June 2012 (n=1210) were screened and the nutritional status assessed using WHO growth standards for weight for height/length. A total of 179 children with moderate acute malnutrition (MAM) (14.8%) and 105 children with severe acute malnutrition (SAM) (8.7%) were detected during this period. Having SAM (compared to MAM) was associated with lower maternal education (p<0.001), lower paternal education (p<0.001), low family income (p=0.022) and mother being a housewife (p=0.009). Prevalence of anaemia among 284 malnourished children was mild 32.4% (n=92), moderate 22.2% (n=63) and severe 0.7% (n=2). Anaemia was highest among infants and prevalence decreased with increasing age. Social determinants played an important role in degree of malnutrition and anaemia among malnourished children admitted to the General Hospital, Vavuniya. PMID:25556413

  15. Possible role of the microbiome in the development of acute malnutrition and implications for food-based strategies to prevent and treat acute malnutrition

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A pattern of changes in the microbiome composition have been observed in the normal maturation of the human gut. Perturbations from this pattern have been described in malnourished humans and reproduced in animal models of severe malnutrition. Treatment and prevention of malnutrition in the future m...

  16. Increased Gut Redox and Depletion of Anaerobic and Methanogenic Prokaryotes in Severe Acute Malnutrition

    PubMed Central

    Million, Matthieu; Tidjani Alou, Maryam; Khelaifia, Saber; Bachar, Dipankar; Lagier, Jean-Christophe; Dione, Niokhor; Brah, Souleymane; Hugon, Perrine; Lombard, Vincent; Armougom, Fabrice; Fromonot, Julien; Robert, Catherine; Michelle, Caroline; Diallo, Aldiouma; Fabre, Alexandre; Guieu, Régis; Sokhna, Cheikh; Henrissat, Bernard; Parola, Philippe; Raoult, Didier

    2016-01-01

    Severe acute malnutrition (SAM) is associated with inadequate diet, low levels of plasma antioxidants and gut microbiota alterations. The link between gut redox and microbial alterations, however, remains unexplored. By sequencing the gut microbiomes of 79 children of varying nutritional status from three centers in Senegal and Niger, we found a dramatic depletion of obligate anaerobes in malnutrition. This was confirmed in an individual patient data meta-analysis including 107 cases and 77 controls from 5 different African and Asian countries. Specifically, several species of the Bacteroidaceae, Eubacteriaceae, Lachnospiraceae and Ruminococceae families were consistently depleted while Enterococcus faecalis, Escherichia coli and Staphylococcus aureus were consistently enriched. Further analyses on our samples revealed increased fecal redox potential, decreased total bacterial number and dramatic Methanobrevibacter smithii depletion. Indeed, M. smithii was detected in more than half of the controls but in none of the cases. No causality was demonstrated but, based on our results, we propose a unifying theory linking microbiota specificity, lacking anaerobes and archaea, to low antioxidant nutrients, and lower food conversion. PMID:27183876

  17. Increased Gut Redox and Depletion of Anaerobic and Methanogenic Prokaryotes in Severe Acute Malnutrition.

    PubMed

    Million, Matthieu; Tidjani Alou, Maryam; Khelaifia, Saber; Bachar, Dipankar; Lagier, Jean-Christophe; Dione, Niokhor; Brah, Souleymane; Hugon, Perrine; Lombard, Vincent; Armougom, Fabrice; Fromonot, Julien; Robert, Catherine; Michelle, Caroline; Diallo, Aldiouma; Fabre, Alexandre; Guieu, Régis; Sokhna, Cheikh; Henrissat, Bernard; Parola, Philippe; Raoult, Didier

    2016-01-01

    Severe acute malnutrition (SAM) is associated with inadequate diet, low levels of plasma antioxidants and gut microbiota alterations. The link between gut redox and microbial alterations, however, remains unexplored. By sequencing the gut microbiomes of 79 children of varying nutritional status from three centers in Senegal and Niger, we found a dramatic depletion of obligate anaerobes in malnutrition. This was confirmed in an individual patient data meta-analysis including 107 cases and 77 controls from 5 different African and Asian countries. Specifically, several species of the Bacteroidaceae, Eubacteriaceae, Lachnospiraceae and Ruminococceae families were consistently depleted while Enterococcus faecalis, Escherichia coli and Staphylococcus aureus were consistently enriched. Further analyses on our samples revealed increased fecal redox potential, decreased total bacterial number and dramatic Methanobrevibacter smithii depletion. Indeed, M. smithii was detected in more than half of the controls but in none of the cases. No causality was demonstrated but, based on our results, we propose a unifying theory linking microbiota specificity, lacking anaerobes and archaea, to low antioxidant nutrients, and lower food conversion. PMID:27183876

  18. Effect of Malnutrition at Diagnosis on Clinical Outcomes of Children With Acute Lymphoblastic Leukemia.

    PubMed

    Yazbeck, Nadine; Samia, Loma; Saab, Raya; Abboud, Miguel R; Solh, Hassan; Muwakkit, Samar

    2016-03-01

    Acute lymphoblastic leukemia (ALL) is the most common malignancy among children. Although studies have shown that malnutrition can negatively affect treatment outcome, results are controversial. This retrospective study aims at determining the prevalence of malnutrition and its association with treatment outcome among children with ALL treated at the Children's Cancer Institute in Lebanon. A total of 103 patients diagnosed with ALL between April 2002 and May 2010 were enrolled. Anthropometric data were collected from medical records upon diagnosis, at 3 and 6 months, and at the end of treatment. Body mass index was calculated for children 2 years of age and older, whereas weight-for-height ratio was used for patients below 2 years. Patients were considered underweight, stunted, or wasted if their Z-scores were <-2 SD. The prevalence of malnourished children was 25.2% at diagnosis and remained almost the same at the end of treatment. The odds of having a poor outcome (death and relapse) was higher among malnourished children and more so among stunted children with an odds ratios=2.15; 95% confidence interval, 0.5-8.3 and odds ratio=2.63; 95% confidence interval, 0.6-11.5, respectively. Although there was a trend showing worse outcomes in malnourished children with ALL at diagnosis when compared with well-nourished children larger studies using additional tools like arm anthropometry need to be conducted to prove the association. PMID:26479995

  19. Mitochondria-associated endoplasmic reticulum membrane (MAM) regulates steroidogenic activity via steroidogenic acute regulatory protein (StAR)-voltage-dependent anion channel 2 (VDAC2) interaction.

    PubMed

    Prasad, Manoj; Kaur, Jasmeet; Pawlak, Kevin J; Bose, Mahuya; Whittal, Randy M; Bose, Himangshu S

    2015-01-30

    Steroid hormones are essential for carbohydrate metabolism, stress management, and reproduction and are synthesized from cholesterol in mitochondria of adrenal glands and gonads/ovaries. In acute stress or hormonal stimulation, steroidogenic acute regulatory protein (StAR) transports substrate cholesterol into the mitochondria for steroidogenesis by an unknown mechanism. Here, we report for the first time that StAR interacts with voltage-dependent anion channel 2 (VDAC2) at the mitochondria-associated endoplasmic reticulum membrane (MAM) prior to its translocation to the mitochondrial matrix. In the MAM, StAR interacts with mitochondrial proteins Tom22 and VDAC2. However, Tom22 knockdown by siRNA had no effect on pregnenolone synthesis. In the absence of VDAC2, StAR was expressed but not processed into the mitochondria as a mature 30-kDa protein. VDAC2 interacted with StAR via its C-terminal 20 amino acids and N-terminal amino acids 221-229, regulating the mitochondrial processing of StAR into the mature protein. In the absence of VDAC2, StAR could not enter the mitochondria or interact with MAM-associated proteins, and therefore steroidogenesis was inhibited. Furthermore, the N terminus was not essential for StAR activity, and the N-terminal deletion mutant continued to interact with VDAC2. The endoplasmic reticulum-targeting prolactin signal sequence did not affect StAR association with the MAM and thus its mitochondrial targeting. Therefore, VDAC2 controls StAR processing and activity, and MAM is thus a central location for initiating mitochondrial steroidogenesis. PMID:25505173

  20. Mitochondria-associated Endoplasmic Reticulum Membrane (MAM) Regulates Steroidogenic Activity via Steroidogenic Acute Regulatory Protein (StAR)-Voltage-dependent Anion Channel 2 (VDAC2) Interaction*

    PubMed Central

    Prasad, Manoj; Kaur, Jasmeet; Pawlak, Kevin J.; Bose, Mahuya; Whittal, Randy M.; Bose, Himangshu S.

    2015-01-01

    Steroid hormones are essential for carbohydrate metabolism, stress management, and reproduction and are synthesized from cholesterol in mitochondria of adrenal glands and gonads/ovaries. In acute stress or hormonal stimulation, steroidogenic acute regulatory protein (StAR) transports substrate cholesterol into the mitochondria for steroidogenesis by an unknown mechanism. Here, we report for the first time that StAR interacts with voltage-dependent anion channel 2 (VDAC2) at the mitochondria-associated endoplasmic reticulum membrane (MAM) prior to its translocation to the mitochondrial matrix. In the MAM, StAR interacts with mitochondrial proteins Tom22 and VDAC2. However, Tom22 knockdown by siRNA had no effect on pregnenolone synthesis. In the absence of VDAC2, StAR was expressed but not processed into the mitochondria as a mature 30-kDa protein. VDAC2 interacted with StAR via its C-terminal 20 amino acids and N-terminal amino acids 221–229, regulating the mitochondrial processing of StAR into the mature protein. In the absence of VDAC2, StAR could not enter the mitochondria or interact with MAM-associated proteins, and therefore steroidogenesis was inhibited. Furthermore, the N terminus was not essential for StAR activity, and the N-terminal deletion mutant continued to interact with VDAC2. The endoplasmic reticulum-targeting prolactin signal sequence did not affect StAR association with the MAM and thus its mitochondrial targeting. Therefore, VDAC2 controls StAR processing and activity, and MAM is thus a central location for initiating mitochondrial steroidogenesis. PMID:25505173

  1. Dietary cysteine is used more efficiently by children with severe acute malnutrition with edema compared with those without edema

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Children with edematous severe acute malnutrition (SAM) produce less cysteine than do their nonedematous counterparts. They also have marked glutathione (GSH) depletion, hair loss, skin erosion, gut mucosal atrophy, and depletion of mucins. Because GSH, skin, hair, mucosal, and mucin proteins are ri...

  2. Evaluation of the routine use of amoxicillin as part of the home-based treatment of severe acute malnutrition

    Technology Transfer Automated Retrieval System (TEKTRAN)

    To determine whether the inclusion of amoxicillin correlates with better recovery rates in the home-based treatment of severe acute malnutrition with ready-to-use therapeutic food. This retrospective cohort study compared data from the treatment of two groups of children in Malawi aged 6-59 months w...

  3. Protein source and quality in therapeutic foods affect the immune response and outcome in severe acute malnutrition

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Protein is a vital component of therapeutic foods designed to treat severe acute malnutrition (SAM) in children; however there are still unknowns about the quality and quantity of the proteins to use in these foods. This review examines two recent studies investigating several different qualities an...

  4. Nutritional repletion of children with severe acute malnutrition does not affect VLDL apolipoprotein B-100 synthesis rate

    Technology Transfer Automated Retrieval System (TEKTRAN)

    VLDL apo B-100 is essential for the secretion of liver fat. It is thought that synthesis of this lipoprotein is impaired in childhood severe acute malnutrition (SAM), especially in the edematous syndromes, and that this contributes to the common occurrence of hepatic steatosis in this condition. How...

  5. Review of the safety and efficacy of vitamin A supplementation in the treatment of children with severe acute malnutrition

    Technology Transfer Automated Retrieval System (TEKTRAN)

    World Health Organization (WHO) guidelines recommend for children with severe acute malnutrition (SAM), high-dose vitamin A (VA) supplements be given on day 1 of admission, and on days 2 and 14 in the case of clinical signs of vitamin A deficiency (VAD). Daily low-dose VA follows, delivered in a pre...

  6. Dietary supplementation with aromatic amino acids increases protein synthesis in children wHh severe acute malnutrition

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Although 2 earlier studies reported that aromatic amino acid (AAA) supplementation of children with severe acute malnutrition (SAM) improved whole-body protein anabolism during the early postadmission (maintenance) phase of rehabilitation, it is not known whether this positive effect was maintained ...

  7. Fidelity in Animal Modeling: Prerequisite for a Mechanistic Research Front Relevant to the Inflammatory Incompetence of Acute Pediatric Malnutrition.

    PubMed

    Woodward, Bill

    2016-01-01

    Inflammatory incompetence is characteristic of acute pediatric protein-energy malnutrition, but its underlying mechanisms remain obscure. Perhaps substantially because the research front lacks the driving force of a scholarly unifying hypothesis, it is adrift and research activity is declining. A body of animal-based research points to a unifying paradigm, the Tolerance Model, with some potential to offer coherence and a mechanistic impetus to the field. However, reasonable skepticism prevails regarding the relevance of animal models of acute pediatric malnutrition; consequently, the fundamental contributions of the animal-based component of this research front are largely overlooked. Design-related modifications to improve the relevance of animal modeling in this research front include, most notably, prioritizing essential features of pediatric malnutrition pathology rather than dietary minutiae specific to infants and children, selecting windows of experimental animal development that correspond to targeted stages of pediatric immunological ontogeny, and controlling for ontogeny-related confounders. In addition, important opportunities are presented by newer tools including the immunologically humanized mouse and outbred stocks exhibiting a magnitude of genetic heterogeneity comparable to that of human populations. Sound animal modeling is within our grasp to stimulate and support a mechanistic research front relevant to the immunological problems that accompany acute pediatric malnutrition. PMID:27077845

  8. Fidelity in Animal Modeling: Prerequisite for a Mechanistic Research Front Relevant to the Inflammatory Incompetence of Acute Pediatric Malnutrition

    PubMed Central

    Woodward, Bill

    2016-01-01

    Inflammatory incompetence is characteristic of acute pediatric protein-energy malnutrition, but its underlying mechanisms remain obscure. Perhaps substantially because the research front lacks the driving force of a scholarly unifying hypothesis, it is adrift and research activity is declining. A body of animal-based research points to a unifying paradigm, the Tolerance Model, with some potential to offer coherence and a mechanistic impetus to the field. However, reasonable skepticism prevails regarding the relevance of animal models of acute pediatric malnutrition; consequently, the fundamental contributions of the animal-based component of this research front are largely overlooked. Design-related modifications to improve the relevance of animal modeling in this research front include, most notably, prioritizing essential features of pediatric malnutrition pathology rather than dietary minutiae specific to infants and children, selecting windows of experimental animal development that correspond to targeted stages of pediatric immunological ontogeny, and controlling for ontogeny-related confounders. In addition, important opportunities are presented by newer tools including the immunologically humanized mouse and outbred stocks exhibiting a magnitude of genetic heterogeneity comparable to that of human populations. Sound animal modeling is within our grasp to stimulate and support a mechanistic research front relevant to the immunological problems that accompany acute pediatric malnutrition. PMID:27077845

  9. Impaired cardiovascular structure and function in adult survivors of severe acute malnutrition.

    PubMed

    Tennant, Ingrid A; Barnett, Alan T; Thompson, Debbie S; Kips, Jan; Boyne, Michael S; Chung, Edward E; Chung, Andrene P; Osmond, Clive; Hanson, Mark A; Gluckman, Peter D; Segers, Patrick; Cruickshank, J Kennedy; Forrester, Terrence E

    2014-09-01

    Malnutrition below 5 years remains a global health issue. Severe acute malnutrition (SAM) presents in childhood as oedematous (kwashiorkor) or nonoedematous (marasmic) forms, with unknown long-term cardiovascular consequences. We hypothesized that cardiovascular structure and function would be poorer in SAM survivors than unexposed controls. We studied 116 adult SAM survivors, 54 after marasmus, 62 kwashiorkor, and 45 age/sex/body mass index-matched community controls who had standardized anthropometry, blood pressure, echocardiography, and arterial tonometry performed. Left ventricular indices and outflow tract diameter, carotid parameters, and pulse wave velocity were measured, with systemic vascular resistance calculated. All were expressed as SD scores. Mean (SD) age was 28.8±7.8 years (55% men). Adjusting for age, sex, height, and weight, SAM survivors had mean (SE) reductions for left ventricular outflow tract diameter of 0.67 (0.16; P<0.001), stroke volume 0.44 (0.17; P=0.009), cardiac output 0.5 (0.16; P=0.001), and pulse wave velocity 0.32 (0.15; P=0.03) compared with controls but higher diastolic blood pressures (by 4.3; 1.2-7.3 mm Hg; P=0.007). Systemic vascular resistance was higher in marasmus and kwashiorkor survivors (30.2 [1.2] and 30.8 [1.1], respectively) than controls 25.3 (0.8), overall difference 5.5 (95% confidence interval, 2.8-8.4 mm Hg min/L; P<0.0001). No evidence of large vessel or cardiac remodeling was found, except closer relationships between these indices in former marasmic survivors. Other parameters did not differ between SAM survivor groups. We conclude that adult SAM survivors had smaller outflow tracts and cardiac output when compared with controls, yet markedly elevated peripheral resistance. Malnutrition survivors are thus likely to develop excess hypertension in later life, especially when exposed to obesity. PMID:24980666

  10. Gut DNA viromes of Malawian twins discordant for severe acute malnutrition.

    PubMed

    Reyes, Alejandro; Blanton, Laura V; Cao, Song; Zhao, Guoyan; Manary, Mark; Trehan, Indi; Smith, Michelle I; Wang, David; Virgin, Herbert W; Rohwer, Forest; Gordon, Jeffrey I

    2015-09-22

    The bacterial component of the human gut microbiota undergoes a definable program of postnatal development. Evidence is accumulating that this program is disrupted in children with severe acute malnutrition (SAM) and that their persistent gut microbiota immaturity, which is not durably repaired with current ready-to-use therapeutic food (RUTF) interventions, is causally related to disease pathogenesis. To further characterize gut microbial community development in healthy versus malnourished infants/children, we performed a time-series metagenomic study of DNA isolated from virus-like particles (VLPs) recovered from fecal samples collected during the first 30 mo of postnatal life from eight pairs of mono- and dizygotic Malawian twins concordant for healthy growth and 12 twin pairs discordant for SAM. Both members of discordant pairs were sampled just before, during, and after treatment with a peanut-based RUTF. Using Random Forests and a dataset of 17,676 viral contigs assembled from shotgun sequencing reads of VLP DNAs, we identified viruses that distinguish different stages in the assembly of the gut microbiota in the concordant healthy twin pairs. This developmental program is impaired in both members of SAM discordant pairs and not repaired with RUTF. Phage plus members of the Anelloviridae and Circoviridae families of eukaryotic viruses discriminate discordant from concordant healthy pairs. These results disclose that apparently healthy cotwins in discordant pairs have viromes associated with, although not necessarily mediators, of SAM; as such, they provide a human model for delineating normal versus perturbed postnatal acquisition and retention of the gut microbiota's viral component in populations at risk for malnutrition. PMID:26351661

  11. Infections in Children Admitted with Complicated Severe Acute Malnutrition in Niger

    PubMed Central

    Page, Anne-Laure; de Rekeneire, Nathalie; Sayadi, Sani; Aberrane, Said; Janssens, Ann-Carole; Rieux, Claire; Djibo, Ali; Manuguerra, Jean-Claude; Ducou-le-Pointe, Hubert; Grais, Rebecca F.; Schaefer, Myrto; Guerin, Philippe J.; Baron, Emmanuel

    2013-01-01

    Background Although malnutrition affects thousands of children throughout the Sahel each year and predisposes them to infections, there is little data on the etiology of infections in these populations. We present a clinical and biological characterization of infections in hospitalized children with complicated severe acute malnutrition (SAM) in Maradi, Niger. Methods Children with complicated SAM hospitalized in the intensive care unit of a therapeutic feeding center, with no antibiotics in the previous 7 days, were included. A clinical examination, blood, urine and stool cultures, and chest radiography were performed systematically on admission. Results Among the 311 children included in the study, gastroenteritis was the most frequent clinical diagnosis on admission, followed by respiratory tract infections and malaria. Blood or urine culture was positive in 17% and 16% of cases, respectively, and 36% had abnormal chest radiography. Enterobacteria were sensitive to most antibiotics, except amoxicillin and cotrimoxazole. Twenty-nine (9%) children died, most frequently from sepsis. Clinical signs were poor indicators of infection and initial diagnoses correlated poorly with biologically or radiography-confirmed diagnoses. Conclusions These data confirm the high level of infections and poor correlation with clinical signs in children with complicated SAM, and provide antibiotic resistance profiles from an area with limited microbiological data. These results contribute unique data to the ongoing debate on the use and choice of broad-spectrum antibiotics as first-line treatment in children with complicated SAM and reinforce the call for an update of international guidelines on management of complicated SAM based on more recent data. PMID:23874731

  12. Gut DNA viromes of Malawian twins discordant for severe acute malnutrition

    PubMed Central

    Reyes, Alejandro; Blanton, Laura V.; Cao, Song; Zhao, Guoyan; Manary, Mark; Trehan, Indi; Smith, Michelle I.; Wang, David; Virgin, Herbert W.; Rohwer, Forest; Gordon, Jeffrey I.

    2015-01-01

    The bacterial component of the human gut microbiota undergoes a definable program of postnatal development. Evidence is accumulating that this program is disrupted in children with severe acute malnutrition (SAM) and that their persistent gut microbiota immaturity, which is not durably repaired with current ready-to-use therapeutic food (RUTF) interventions, is causally related to disease pathogenesis. To further characterize gut microbial community development in healthy versus malnourished infants/children, we performed a time-series metagenomic study of DNA isolated from virus-like particles (VLPs) recovered from fecal samples collected during the first 30 mo of postnatal life from eight pairs of mono- and dizygotic Malawian twins concordant for healthy growth and 12 twin pairs discordant for SAM. Both members of discordant pairs were sampled just before, during, and after treatment with a peanut-based RUTF. Using Random Forests and a dataset of 17,676 viral contigs assembled from shotgun sequencing reads of VLP DNAs, we identified viruses that distinguish different stages in the assembly of the gut microbiota in the concordant healthy twin pairs. This developmental program is impaired in both members of SAM discordant pairs and not repaired with RUTF. Phage plus members of the Anelloviridae and Circoviridae families of eukaryotic viruses discriminate discordant from concordant healthy pairs. These results disclose that apparently healthy cotwins in discordant pairs have viromes associated with, although not necessarily mediators, of SAM; as such, they provide a human model for delineating normal versus perturbed postnatal acquisition and retention of the gut microbiota’s viral component in populations at risk for malnutrition. PMID:26351661

  13. Acute phase reactants in Sudanese children with severe protein-energy malnutrition*

    PubMed Central

    Suliman, Omer S. M.; Salih, Mustafa A. M.; Karrar, Zein A.; Mohammed, Abdelrahim O.; Helsing, Chrestover

    2011-01-01

    The pre-dietary rehabilitation levels of acute phase proteins (APP) namely, alpha-1-antitrypsin (AAT), orosomucoid (ORO), haptoglobin (HAP), fibrinogen (FIB) and C-reactive protein (CRP) in the plasma of Sudanese children with severe protein energy malnutrition (PEM) were compared with those of normal controls, and with the levels after dietary rehabilitation. Eighty one children were included in the study; 49 with severe PEM (23 with marasmus, 17 with marasmic-kwashiorkor and 9 with kwashiorkor), 13 with tuberculosis (TB) and 19 healthy children as controls. The study showed a high incidence of infections, especially acute respiratory infection (ARI), diarrhoeal diseases and intestinal parasites in the malnourished children. The mean plasma level of albumin was significantly lower in the malnourished children compared to controls (P<0.001), with kwashiorkor children showing the lowest mean level. This hypoalbuminaemia was significantly associated with the presence of ARI and intestinal parasites. The mean plasma levels of the APP, except FIB, were significantly higher in malnourished children than in controls, with higher levels associated with ARI and the presence of fever. Malnourished children with TB had significantly higher mean levels of the APP (AAT, HAP, FIB, CRP) compared to those without TB. The mean levels of HAP and AAT were significantly lower in the presence of diarrhoea, suggesting their loss in the stool. The mean levels of the APP after two weeks dietary rehabilitation and antimicrobial treatment showed a significant drop in only two of the APP, namely CRP, ORO, while FIB showed a significant rise.

  14. Choice of design and outcomes in trials among children with moderate acute malnutrition.

    PubMed

    Friis, Henrik; Michaelsen, Kim F; Wells, Jonathan C

    2015-03-01

    There is a need for trials on the effects of food aid products for children with moderate acute malnutrition, to identify how best to restore body tissues and function. The choice of control intervention is a major challenge, with both ethical and scientific implications. While randomized trials are needed, special designs, such as cluster-randomized, stepped-wedged or factorial designs may offer advantages. Anthropometry is widely used as the primary outcome in such trials, but anthropometric traits do not refer directly to specific organs, tissues, or functions. Thus, it is difficult to understand what components of health might be impacted by public health programs, or the underlying mechanisms whereby improved nutritional status might benefit short- and long-term health. Measurement of body composition, specific growth markers and functional outcomes may provide greater insight into the nature and implications of growth failure and recovery. There are now several methodologies suitable for application in infants and young children, e.g., measuring body composition with deuterium dilution, physical activity with accelerometers and linear growth with knemometers. To evaluate the generalizability of the findings from nutrition trials, it is important to collect data on baseline nutritional status. PMID:25902612

  15. An evaluation of the routine use of amoxicillin as part of the home-based treatment of severe acute malnutrition

    PubMed Central

    Trehan, Indi; Amthor, Rachel E.; Maleta, Kenneth; Manary, Mark J.

    2010-01-01

    Objective To determine if the inclusion of amoxicillin correlates with better recovery rates in the home-based treatment of severe acute malnutrition with ready-to-use therapeutic food. Methods This retrospective cohort study compared data from the treatment of two groups of children in Malawi aged 6–59 months with uncomplicated severe acute malnutrition. The standard protocol group received a 7 day course of amoxicillin at the onset of treatment. The alternate protocol group received no antibiotics. All children were treated with the same ready-to-use therapeutic food. The primary outcome was nutritional recovery, defined as achieving a weight-for-height Z-score > −2 without edema. Results 498 children were treated according to the standard protocol with amoxicillin and 1955 were treated under the alternate protocol without antibiotics. The group of children treated with amoxicillin was slightly older and more stunted at baseline. The recovery rate for children who received amoxicillin was worse at 4 weeks (40% vs. 71%) but similar after up to 12 weeks of therapy (84% vs. 86%), compared to the children treated without antibiotics. Regression modeling indicated that this difference at 4 weeks was most strongly associated with the receipt of amoxicillin. Conclusions This review of two therapeutic feeding programs suggests that children with severe acute malnutrition who were treated without amoxicillin did not have an inferior rate of recovery. Given the limitations of this retrospective analysis, a prospective trial is warranted to determine the effect of antibiotics on recovery from uncomplicated malnutrition with home-based therapy. PMID:20545919

  16. Coverage of Community-Based Management of Severe Acute Malnutrition Programmes in Twenty-One Countries, 2012-2013

    PubMed Central

    Rogers, Eleanor; Myatt, Mark; Woodhead, Sophie; Guerrero, Saul; Alvarez, Jose Luis

    2015-01-01

    Objective This paper reviews coverage data from programmes treating severe acute malnutrition (SAM) collected between July 2012 and June 2013. Design This is a descriptive study of coverage levels and barriers to coverage collected by coverage assessments of community-based SAM treatment programmes in 21 countries that were supported by the Coverage Monitoring Network. Data from 44 coverage assessments are reviewed. Setting These assessments analyse malnourished populations from 6 to 59 months old to understand the accessibility and coverage of services for treatment of acute malnutrition. The majority of assessments are from sub-Saharan Africa. Results Most of the programmes (33 of 44) failed to meet context-specific internationally agreed minimum standards for coverage. The mean level of estimated coverage achieved by the programmes in this analysis was 38.3%. The most frequently reported barriers to access were lack of awareness of malnutrition, lack of awareness of the programme, high opportunity costs, inter-programme interface problems, and previous rejection. Conclusions This study shows that coverage of CMAM is lower than previous analyses of early CTC programmes; therefore reducing programme impact. Barriers to access need to be addressed in order to start improving coverage by paying greater attention to certain activities such as community sensitisation. As barriers are interconnected focusing on specific activities, such as decentralising services to satellite sites, is likely to increase significantly utilisation of nutrition services. Programmes need to ensure that barriers are continuously monitored to ensure timely removal and increased coverage. PMID:26042827

  17. Changes in whole-blood PUFA and their predictors during recovery from severe acute malnutrition.

    PubMed

    Babirekere-Iriso, Esther; Mortensen, Charlotte G; Mupere, Ezekiel; Rytter, Maren J H; Namusoke, Hanifa; Michaelsen, Kim F; Briend, André; Stark, Ken D; Friis, Henrik; Lauritzen, Lotte

    2016-05-01

    Children with severe acute malnutrition (SAM) with complications require in-patient management including therapeutic feeding. Little attention has been given to the effects of these feeds on the essential fatty acid status of children with SAM. The objective of this study was to describe changes in the PUFA composition in whole blood in children with SAM during treatment and to determine predictors of change. This prospective study took place in a paediatric nutrition rehabilitation unit in Kampala, Uganda, and assessed whole-blood fatty acid composition of children with SAM at admission, transition, discharge and follow-up (8 and 16 weeks). ANCOVA was used to identify predictors of change in whole-blood PUFA. The study included 120 children with SAM and twenty-nine healthy control children of similar age and sex. Among the SAM children, 38 % were female and 64 % had oedema. Whole-blood n-6 PUFA proportions increased from admission to follow-up, except for arachidonic acid, which decreased by 0·79 (95 % CI 0·46, 1·12) fatty acid percentage (FA%) from admission to transition and 0·10 (95 % CI 0·23, 0·44) FA% at discharge. n-3 Long-chain (LC) PUFA decreased by 0·21 (95 % CI 0·03, 0·40) FA% at discharge and 0·22 (95 % CI 0·01, 0·42) FA% at 8 weeks of follow-up. This decrease was greater in children from families with recent fish intake and those with nasogastric tube feeding. Current therapeutic feeds do not correct whole-blood levels of LCPUFA, particularly n-3 LCPUFA, in children with SAM. Increased attention is needed to the contents of n-3 LCPUFA in therapeutic feeds. PMID:26996197

  18. Community-Based Management of Child Malnutrition in Zambia: HIV/AIDS Infection and Other Risk Factors on Child Survival

    PubMed Central

    Moramarco, Stefania; Amerio, Giulia; Ciarlantini, Clarice; Chipoma, Jean Kasengele; Simpungwe, Matilda Kakungu; Nielsen-Saines, Karin; Palombi, Leonardo; Buonomo, Ersilia

    2016-01-01

    (1) Background: Supplementary feeding programs (SFPs) are effective in the community-based treatment of moderate acute malnutrition (MAM) and prevention of severe acute malnutrition (SAM); (2) Methods: A retrospective study was conducted on a sample of 1266 Zambian malnourished children assisted from 2012 to 2014 in the Rainbow Project SFPs. Nutritional status was evaluated according to WHO/Unicef methodology. We performed univariate and multivariate Cox proportional risk regression to identify the main predictors of mortality. In addition, a time-to event analysis was performed to identify predictors of failure and time to cure events; (3) Results: The analysis included 858 malnourished children (19 months ± 9.4; 49.9% males). Program outcomes met international standards with a better performance for MAM compared to SAM. Cox regression identified SAM (3.8; 2.1–6.8), HIV infection (3.1; 1.7–5.5), and WAZ <−3 (3.1; 1.6–5.7) as predictors of death. Time to event showed 80% of children recovered by SAM/MAM at 24 weeks. (4) Conclusions: Preventing deterioration of malnutrition, coupled to early detection of HIV/AIDS with adequate antiretroviral treatment, and extending the duration of feeding supplementation, could be crucial elements for ensuring full recovery and improve child survival in malnourished Zambian children. PMID:27376317

  19. Community-Based Management of Child Malnutrition in Zambia: HIV/AIDS Infection and Other Risk Factors on Child Survival.

    PubMed

    Moramarco, Stefania; Amerio, Giulia; Ciarlantini, Clarice; Chipoma, Jean Kasengele; Simpungwe, Matilda Kakungu; Nielsen-Saines, Karin; Palombi, Leonardo; Buonomo, Ersilia

    2016-01-01

    (1) BACKGROUND: Supplementary feeding programs (SFPs) are effective in the community-based treatment of moderate acute malnutrition (MAM) and prevention of severe acute malnutrition (SAM); (2) METHODS: A retrospective study was conducted on a sample of 1266 Zambian malnourished children assisted from 2012 to 2014 in the Rainbow Project SFPs. Nutritional status was evaluated according to WHO/Unicef methodology. We performed univariate and multivariate Cox proportional risk regression to identify the main predictors of mortality. In addition, a time-to event analysis was performed to identify predictors of failure and time to cure events; (3) RESULTS: The analysis included 858 malnourished children (19 months ± 9.4; 49.9% males). Program outcomes met international standards with a better performance for MAM compared to SAM. Cox regression identified SAM (3.8; 2.1-6.8), HIV infection (3.1; 1.7-5.5), and WAZ <-3 (3.1; 1.6-5.7) as predictors of death. Time to event showed 80% of children recovered by SAM/MAM at 24 weeks. (4) CONCLUSIONS: Preventing deterioration of malnutrition, coupled to early detection of HIV/AIDS with adequate antiretroviral treatment, and extending the duration of feeding supplementation, could be crucial elements for ensuring full recovery and improve child survival in malnourished Zambian children. PMID:27376317

  20. Do Children with Uncomplicated Severe Acute Malnutrition Need Antibiotics? A Systematic Review and Meta-Analysis

    PubMed Central

    Alcoba, Gabriel; Kerac, Marko; Breysse, Serge; Salpeteur, Cécile; Galetto-Lacour, Annick; Briend, André; Gervaix, Alain

    2013-01-01

    Background Current (1999) World Health Organization guidelines recommend giving routine antibiotics (AB) for all children with severe acute malnutrition (SAM), even if they have uncomplicated disease with no clinically obvious infections. We examined the evidence behind this recommendation. Methods and Findings OVID-MEDLINE, EMBASE, COCHRANE, GLOBAL-HEALTH, CINAHL, POPLINE, AFRICA-WIDE-NiPAD, and LILACS were searched for AB efficacy, bacterial resistance, and infection rates in SAM. Following PRISMA guidelines, a systematic review and meta-analysis were performed. Three randomised controlled trials (RCT), five Cochrane reviews, and 37 observational studies were identified. One cohort-study showed no increase in nutritional-cure and mortality in uncomplicated SAM where no AB were used. (p>0.05). However, an unpublished RCT in this setting did show mortality benefits. Another RCT did not show superiority of ceftriaxone over amoxicilllin for these same outcomes, but adressed SAM children with and without complications (p = 0.27). Another RCT showed no difference between amoxicillin and cotrimoxazole efficacies for pneumonia in underweight, but not SAM. Our meta-analysis of 12 pooled susceptibility-studies for all types of bacterial isolates, including 2767 stricly SAM children, favoured amoxicillin over cotrimoxazole for susceptibility medians: 42% (IQR 27–55%) vs 22% (IQR 17–23%) and population-weighted-means 52.9% (range 23–57%) vs 35.4% (range 6.7–42%). Susceptibilities to second-line AB were better, above 80%. Prevalence of serious infections in SAM, pooled from 24 studies, ranged from 17% to 35.2%. No study infered any association of infection prevalence with AB regimens in SAM. Conclusions The evidence underlying current antibiotic recommendations for uncomplicated SAM is weak. Susceptibility-studies favour amoxicillin over cotrimoxazole. However, given that these antibiotics have side-effects, costs, and risks as well as benefits, their routine use

  1. Cost-effectiveness of the community-based management of severe acute malnutrition by community health workers in southern Bangladesh.

    PubMed

    Puett, Chloe; Sadler, Kate; Alderman, Harold; Coates, Jennifer; Fiedler, John L; Myatt, Mark

    2013-07-01

    This study assessed the cost-effectiveness of adding the community-based management of severe acute malnutrition (CMAM) to a community-based health and nutrition programme delivered by community health workers (CHWs) in southern Bangladesh. The cost-effectiveness of this model of treatment for severe acute malnutrition (SAM) was compared with the cost-effectiveness of the 'standard of care' for SAM (i.e. inpatient treatment), augmented with community surveillance by CHWs to detect cases, in a neighbouring area. An activity-based cost model was used, and a societal perspective taken, to include all costs incurred in the programme by providers and participants for the management of SAM in both areas. Cost data were coupled with programme effectiveness data. The community-based strategy cost US$26 per disability-adjusted life year (DALY) averted, compared with US$1344 per DALY averted for inpatient treatment. The average cost to participant households for their child to recover from SAM in community treatment was one-sixth that of inpatient treatment. These results suggest that this model of treatment for SAM is highly cost-effective and that CHWs, given adequate supervision and training, can be employed effectively to expand access to treatment for SAM in Bangladesh. PMID:22879522

  2. Child acute malnutrition and mortality in populations affected by displacement in the Horn of Africa, 1997-2009.

    PubMed

    Mason, John B; White, Jessica M; Heron, Linda; Carter, Jennifer; Wilkinson, Caroline; Spiegel, Paul

    2012-03-01

    Drought and conflict in the Horn of Africa are causing population displacement, increasing risks of child mortality and malnutrition. Humanitarian agencies are trying to mitigate the impact, with limited resources. Data from previous years may help guide decisions. Trends in different populations affected by displacement (1997-2009) were analyzed to investigate: (1) how elevated malnutrition and mortality were among displaced compared to host populations; (2) whether the mortality/malnutrition relation changed through time; and (3) how useful is malnutrition in identifying high mortality situations. Under-five mortality rates (usually from 90-day recall, as deaths/10,000/day: U5MR) and global acute malnutrition (wasting prevalences, < -2SDs of references plus edema: GAM) were extracted from reports of 1,175 surveys carried out between 1997-2009 in the Horn of Africa; these outcome indicators were analyzed by livelihood (pastoral, agricultural) and by displacement status (refugee/internally displaced, local resident/host population, mixed); associations between these indicators were examined, stratifying by status. Patterns of GAM and U5MR plotted over time by country and livelihood clarified trends and showed substantial correspondence. Over the period GAM was steady but U5MR generally fell by nearly half. Average U5MR was similar overall between displaced and local residents. GAM was double on average for pastoralists compared with agriculturalists (17% vs. 8%), but was not different between displaced and local populations. Agricultural populations showed increased U5MR when displaced, in contrast to pastoralist. U5MR rose sharply with increasing GAM, at different GAM thresholds depending on livelihood. Higher GAM cut-points for pastoralists than agriculturalists would better predict elevated U5MR (1/10,000/day) or emergency levels (2/10,000/day) in the Horn of Africa; cut-points of 20-25% GAM in pastoral populations and 10-15% GAM in agriculturalists are

  3. Severe Acute Malnutrition in Childhood: Hormonal and Metabolic Status at Presentation, Response to Treatment, and Predictors of Mortality

    PubMed Central

    Bartz, Sarah; Mody, Aaloke; Hornik, Christoph; Bain, James; Muehlbauer, Michael; Kiyimba, Tonny; Kiboneka, Elizabeth; Stevens, Robert; Bartlett, John; St Peter, John V.; Newgard, Christopher B.

    2014-01-01

    Objective: Malnutrition is a major cause of childhood morbidity and mortality. To identify and target those at highest risk, there is a critical need to characterize biomarkers that predict complications prior to and during treatment. Methods: We used targeted and nontargeted metabolomic analysis to characterize changes in a broad array of hormones, cytokines, growth factors, and metabolites during treatment of severe childhood malnutrition. Children aged 6 months to 5 years were studied at presentation to Mulago Hospital and during inpatient therapy with milk-based formulas and outpatient supplementation with ready-to-use food. We assessed the relationship between baseline hormone and metabolite levels and subsequent mortality. Results: Seventy-seven patients were enrolled in the study; a subset was followed up from inpatient treatment to the outpatient clinic. Inpatient and outpatient therapies increased weight/height z scores and induced striking changes in the levels of fatty acids, amino acids, acylcarnitines, inflammatory cytokines, and various hormones including leptin, insulin, GH, ghrelin, cortisol, IGF-I, glucagon-like peptide-1, and peptide YY. A total of 12.2% of the patients died during hospitalization; the major biochemical factor predicting mortality was a low level of leptin (P = .0002), a marker of adipose tissue reserve and a critical modulator of immune function. Conclusions: We have used metabolomic analysis to provide a comprehensive hormonal and metabolic profile of severely malnourished children at presentation and during nutritional rehabilitation. Our findings suggest that fatty acid metabolism plays a central role in the adaptation to acute malnutrition and that low levels of the adipose tissue hormone leptin associate with, and may predict, mortality prior to and during treatment. PMID:24606092

  4. Malnutrition Tests

    MedlinePlus

    ... be limited. Home Visit Global Sites Search Help? Malnutrition Share this page: Was this page helpful? Overview | Symptoms | Tests | Treatment | Related Pages Tests Malnutrition will often be noticeable to the doctor's trained ...

  5. [Malnutrition and poverty in Colombia].

    PubMed

    Rico Velasco, J; Acciarri, G; Fajardo, L F

    1982-01-01

    A history of colonial exploitation and a development model that concentrates wealth and excludes a large proportion of the population from the development process are the principal determinants of income distribution in Colombia. This work analyzes the extent of malnutrition among the poorest 30% of the Colombian population. The National Plan for Feeding and Nutrition (PAN), an important component of the national development plan, strives to improve the nutritional status of the most vulnerable population groups living in rural areas and marginal urban neighborhoods, with particular emphasis on mothers and children. The program initially was focussed on 11 priority regions where 5 types of interventions were developed: primary health care, environmental sanitation, food production, food distribution, and nutrition education. Because of the good results initially obtained, PAN now covers the entire national territory. A 1977 survey stratified by socioeconomic levels indicated that among the poorest 30% of the population, 67% of the children examined had low weight for age caused by a combination of chronic and acute malnutrition. 12% were considered to have severe and 23% moderate malnutrition. 8% had severe and 17% had moderate problems of height for age. 26% had deficient weight for height. Comparison of the data to normal values published by the World Health Organization clearly demonstrates the pattern of overall malnutrition indicated by weight for age figures. It can be concluded at 33% of children in the poorest 30% of the population are normal, 31% have mild malnutrition, 23% moderate malnutrition, and 12% severe malnutrition. Data on height for age indicated that 43% were normal, 32% had mild chronic malnutrition, 17% had moderate chronic malnutrition, and 8% had severe chronic malnutrition. The prevalence of acute malnutrition in the poor population measured by the ratio of weight to height was less than that of chronic or overall malnutrition. 21% were

  6. Current MUAC Cut-Offs to Screen for Acute Malnutrition Need to Be Adapted to Gender and Age: The Example of Cambodia

    PubMed Central

    Fiorentino, Marion; Sophonneary, Prak; Laillou, Arnaud; Whitney, Sophie; de Groot, Richard; Perignon, Marlène; Kuong, Khov; Berger, Jacques; Wieringa, Frank T.

    2016-01-01

    Background Early identification of children <5 yrs with acute malnutrition is a priority. Acute malnutrition is defined by the World Health Organization as a mid-upper-arm circumference (MUAC) <12.5 cm or a weight-for-height Z-score (WHZ) <-2. MUAC is a simple and low-cost indicator to screen for acute malnutrition in communities, but MUAC cut-offs currently recommended by WHO do not identify the majority of children with weight-for-height Z-score (<-2 (moderate malnourished) or r<-3 (severe malnourished). Also, no cut-offs for MUAC are established for children >5 yrs. Therefore, this study aimed at defining gender and age-specific cut-offs to improve sensitivity of MUAC as an indicator of acute malnutrition. Methods To establish new age and gender-specific MUAC cut-offs, pooled data was obtained for 14,173 children from 5 surveys in Cambodia (2011–2013). Sensitivity, false positive rates, and areas under receiver-operator characteristic curves (AUC) were calculated using wasting for children <5yrs and thinness for children ≥5yrs as gold standards. Among the highest values of AUC, the cut-off with the highest sensitivity and a false positive rate ≤33% was selected as the optimal cut-off. Results Optimal cut-off values increased with age. Boys had higher cut-offs than girls, except in the 8–10.9 yrs age range. In children <2yrs, the cut-off was lower for stunted children compared to non stunted children. Sensitivity of MUAC to identify WHZ<-2 and <-3 z-scores increased from 24.3% and 8.1% to >80% with the new cut-offs in comparison with the current WHO cut-offs. Conclusion Gender and age specific MUAC cut-offs drastically increased sensitivity to identify children with WHZ-score <-2 z-scores. International reference of MUAC cut-offs by age group and gender should be established to screen for acute malnutrition at the community level. PMID:26840899

  7. Treatment outcome and factors affecting time to recovery in children with severe acute malnutrition treated at outpatient therapeutic care program

    PubMed Central

    Mengesha, Melkamu Merid; Deyessa, Negussie; Tegegne, Balewgizie Sileshi; Dessie, Yadeta

    2016-01-01

    Background The outpatient therapeutic care program (OTP) of children with severe acute malnutrition (SAM) has been decentralized to health post level in Ethiopia since 2008–2009. However, there is a lack of evidence regarding treatment outcomes and factors related to the duration of stay on treatment after its decentralization to health post level. Objective This study was aimed to assess treatment outcome and factors affecting time to recovery in children with SAM treated at OTP. Design Health facility–based retrospective cohort study was conducted using data from 348 patient cards. The outcome variable was time to recovery. Descriptive analysis was done using percentages for categorical data and mean/median for continuous variables. A robust method of analyzing time to event data, the Cox proportional-hazard regression, was used. All statistical tests in this study are declared significant at p<0.05. Result 89.1% of children with kwashiorkor and 69.4% of children with marasmus were recovered. Of the total children studied, 22% were readmitted cases. The median time of recovery was 35 days for children with kwashiorkor and 49 days for children with marasmus. Children older than 3 years were 33% less likely to achieve nutritional recovery [adjusted hazard ratio, AHR=0.67, 95% confidence interval, CI (0.46, 0.97)]. Similarly, marasmic children stayed longer on treatment [AHR=0.42, 95% CI (0.32, 0.56)]. However, children who gained Mid-Upper Arm Circumference (MUAC) ≥ 0.24 mm/day were 59% more likely to recover faster [AHR=1.59, 95% CI (1.23, 2.06)]. Conclusions Close monitoring of weight and MUAC gain to assess nutritional improvement with due emphasis given to children with lower admission weight, children of age 3 years and above and marasmic children will have a positive effect on treatment duration and outcome. PMID:27396484

  8. Perspectives for integration into the local health system of community-based management of acute malnutrition in children under 5 years: a qualitative study in Bangladesh

    PubMed Central

    2014-01-01

    Background Acute malnutrition is a major cause of death among under-five children in low- and middle-income countries. United Nations agencies recommend the integration of community-based management of acute malnutrition (CMAM) into the local health systems for sustainability. The objective of the study was to assess the preparedness of the health system to implement CMAM targeting children under-five years in two sub-districts of Bangladesh. Methods The assessment was performed through direct observation of 44 health centres, individual interviews of seven policy makers, three donors, four health and nutrition implementing partners, 29 health workers, and review of secondary data. Assessment themes, derived from the WHO six Building Blocks, were nutrition governance, nutrition financing, health service delivery, human resources, equipment and supply, referral, monitoring and supervision mechanism. They were subdivided into 16 criteria. Findings were compared with CMAM operational recommendations according to WHO, Valid International and Food and Nutrition Technical Assistance guidelines. Results The government of Bangladesh has developed inpatient and outpatient CMAM guidelines, and a policy offering free-of-charge health care for under-five children. Nutrition coordination was not under full government leadership. Most of funds (74%) dedicated to CMAM were provided by donors, for short-term interventions. Of the total 44 health centres assessed, 39 (88.6%) were active, among which 4 (10.2%) delivered inpatient services, 35 (89.8%) outpatient services, and 24 (61.5%) outreach services. These were regarded as opportunities to include CMAM activities. There were 48.9% vacant positions and the health workers were not trained for management of acute malnutrition. Equipment and supplies did not meet the operational recommendations for management of acute malnutrition. Conclusion Implementing CMAM through the health centres of both sub-districts would warrant

  9. Diarrhoea Complicating Severe Acute Malnutrition in Kenyan Children: A Prospective Descriptive Study of Risk Factors and Outcome

    PubMed Central

    Talbert, Alison; Thuo, Nahashon; Karisa, Japhet; Chesaro, Charles; Ohuma, Eric; Ignas, James; Berkley, James A.; Toromo, Christopher; Atkinson, Sarah; Maitland, Kathryn

    2012-01-01

    Background Severe acute malnutrition (SAM) accounts for two million deaths worldwide annually. In those hospitalised with SAM, concomitant infections and diarrhoea are frequent complications resulting in adverse outcome. We examined the clinical and laboratory features on admission and outcome of children with SAM and diarrhoea at a Kenyan district hospital. Methods A 4-year prospective descriptive study involving 1,206 children aged 6 months to 12 years, hospitalized with SAM and managed in accordance with WHO guidelines. Data on clinical features, haematological, biochemical and microbiological findings for children with diarrhoea (≥3 watery stools/day) were systematically collected and analyzed to identify risk factors associated with poor outcome. Results At admission 592 children (49%) had diarrhoea of which 122 (21%) died compared to 72/614 (12%) deaths in those without diarrhoea at admission (Χ2 = 17.6 p<0.001). A further 187 (16%) children developed diarrhoea after 48 hours of admission and 33 died (18%). Any diarrhoea during admission resulted in a significantly higher mortality 161/852 (19%) than those uncomplicated by diarrhoea 33/351 (9%) (Χ2 = 16.6 p<0.001). Features associated with a fatal outcome in children presenting with diarrhoea included bacteraemia, hyponatraemia, low mid-upper arm circumference <10 cm, hypoxia, hypokalaemia and oedema. Bacteraemia had the highest risk of death (adjusted OR 6.1; 95% C.I 2.3, 16.3 p<0.001); and complicated 24 (20%) of fatalities. Positive HIV antibody status was more frequent in cases with diarrhoea at admission (23%) than those without (15%, Χ2 = 12.0 p = 0.001) but did not increase the risk of death in diarrhoea cases. Conclusion Children with SAM complicated by diarrhoea had a higher risk of death than those who did not have diarrhoea during their hospital stay. Further operational and clinical research is needed to reduce mortality in children with SAM in the given setting. PMID:22675542

  10. Perceptions of usage and unintended consequences of provision of ready-to-use therapeutic food for management of severe acute child malnutrition. A qualitative study in Southern Ethiopia

    PubMed Central

    Tadesse, Elazar; Berhane, Yemane; Hjern, Anders; Olsson, Pia; Ekström, Eva-Charlotte

    2015-01-01

    Background: Severe acute child malnutrition (SAM) is associated with high risk of mortality. To increase programme effectiveness in management of SAM, community-based management of acute malnutrition (CMAM) programme that treats SAM using ready-to-use-therapeutic foods (RUTF) has been scaled-up and integrated into existing government health systems. The study aimed to examine caregivers’ and health workers perceptions of usages of RUTF in a chronically food insecure area in South Ethiopia. Methods: This qualitative study recorded, transcribed and translated focus group discussions and individual interviews with caregivers of SAM children and community health workers (CHWs). Data were complemented with field notes before qualitative content analysis was applied. Results: RUTF was perceived and used as an effective treatment of SAM; however, caregivers also see it as food to be shared and when necessary a commodity to be sold for collective benefits for the household. Caregivers expected prolonged provision of RUTF to contribute to household resources, while the programme guidelines prescribed RUTF as a short-term treatment to an acute condition in a child. To get prolonged access to RUTF caregivers altered the identities of SAM children and sought multiple admissions to CMAM programme at different health posts that lead to various control measures by the CHWs. Conclusion: Even though health workers provide RUTF as a treatment for SAM children, their caregivers use it also for meeting broader food and economic needs of the household endangering the effectiveness of CMAM programme. In chronically food insecure contexts, interventions that also address economic and food needs of entire household are essential to ensure successful treatment of SAM children. This may need a shift to view SAM as a symptom of broader problems affecting a family rather than a disease in an individual child. PMID:25749873

  11. Hunger and Malnutrition

    MedlinePlus

    ... Things to Know About Zika & Pregnancy Hunger and Malnutrition KidsHealth > For Parents > Hunger and Malnutrition Print A ... to meet their needs. What Are Hunger and Malnutrition? Everyone feels hungry at times. Hunger is the ...

  12. Hunger and Malnutrition

    MedlinePlus

    ... I Help a Friend Who Cuts? Hunger and Malnutrition KidsHealth > For Teens > Hunger and Malnutrition Print A ... most of the time. What Are Hunger and Malnutrition? We all feel hungry at times. Hunger is ...

  13. Follow-Up of Post-Discharge Growth and Mortality after Treatment for Severe Acute Malnutrition (FuSAM Study): A Prospective Cohort Study

    PubMed Central

    Kerac, Marko; Bunn, James; Chagaluka, George; Bahwere, Paluku; Tomkins, Andrew; Collins, Steve; Seal, Andrew

    2014-01-01

    Background Management of Severe Acute Malnutrition (SAM) plays a vital role in achieving global child survival targets. Effective treatment programmes are available but little is known about longer term outcomes following programme discharge. Methods From July 2006 to March 2007, 1024 children (median age 21.5 months, IQR 15–32) contributed 1187 admission episodes to an inpatient-based SAM treatment centre in Blantyre, Malawi. Long term outcomes, were determined in a longitudinal cohort study, a year or more after initial programme discharge. We found information on 88%(899/1024). Results In total, 42%(427/1024) children died during or after treatment. 25%(105/427) of deaths occurred after normal programme discharge, >90 days after admission. Mortality was greatest among HIV seropositive children: 62%(274/445). Other risk factors included age <12 months; severity of malnutrition at admission; and disability. In survivors, weight-for-height and weight-for-age improved but height-for-age remained low, mean −2.97 z-scores (SD 1.3). Conclusions Although SAM mortality in this setting was unacceptably high, our findings offer important lessons for future programming, policy and research. First is the need for improved programme evaluation: most routine reporting systems would have missed late deaths and underestimated total mortality due to SAM. Second, a more holistic view of SAM is needed: while treatment will always focus on nutritional interventions, it is vital to also identify and manage underlying clinical conditions such as HIV and disability. Finally early identification and treatment of SAM should be emphasised: our results suggest that this could improve longer term as well as short term outcomes. As international policy and programming becomes increasingly focused on stunting and post-malnutrition chronic disease outcomes, SAM should not be forgotten. Proactive prevention and treatment services are essential, not only to reduce mortality in the short term

  14. Prevalence of malnutrition, diarrhea, and acute respiratory infections among under-five children of Sugali tribe of Chittoor district, Andhra Pradesh, India

    PubMed Central

    Reddy, Venkatashiva B.; Kusuma, Yadlapalli S.; Pandav, Chandrakant S.; Goswami, Anil Kumar; Krishnan, Anand

    2016-01-01

    Introduction: Over a period, tribal population has migrated to cities in search of livelihood. Data on various health problems of the tribes are sparse. Sugalis constitute the third largest tribe in Andhra Pradesh and have settlements in urban areas. Objective: To estimate the prevalence of malnutrition, diarrhea, and acute respiratory infections (ARI) among under-five children of Sugali tribe living in Chittoor district of Andhra Pradesh state in South India. Materials and Methods: A community-based cross-sectional study was conducted in four community blocks/mandals in 2012. A total of 500 Sugali households with under-five were identified. Demographic details, episodes of diarrhea, and ARI among under-five children and treatment/care seeking behavior were collected from mothers/care givers by interview. Nutritional status was assessed using new WHO standards. Results: Of the total 669 children in these 500 households, 343 (51.3%) were girls and 326 (48.7%) were boys. In the last 1 month, 21.4% (18.4-24.6) reported diarrhea and 51.6% (47.7-55.3) reported ARI. The prevalence of underweight, wasting, and stunting among under-five children was 32.7% (29.1-36.4), 18.3% (15.3-21.4), and 38.3% (34.2-41.9), respectively. Majority (70%) sought treatment for illness in modern system of medicine and only few continued with the practice of herbs and traditional medicine. Discussion: Despite living in urban area, the tribal children had high prevalence of malnutrition, diarrhea, and ARI, though lower compared to other tribes in India possibly due to improved access to health care services. Efforts need to be strengthened for social inclusion of tribes into mainstream. PMID:27433066

  15. Malnutrition, a Global Problem

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Malnutrition is a general term for medical conditions caused by an inadequate diet and poor nutrition. Hunger and malnutrition are among the major difficulties confronting many countries around the world. Malnutrition can be caused by several factors, such as the sharp increase in population (curren...

  16. Treatment Failure and Mortality amongst Children with Severe Acute Malnutrition Presenting with Cough or Respiratory Difficulty and Radiological Pneumonia

    PubMed Central

    Chisti, Mohammod Jobayer; Salam, Mohammed Abdus; Bardhan, Pradip Kumar; Faruque, Abu S. G.; Shahid, Abu S. M. S. B.; Shahunja, K. M.; Das, Sumon Kumar; Hossain, Md Iqbal; Ahmed, Tahmeed

    2015-01-01

    Background Appropriate intervention is critical in reducing deaths among under-five, severe acutely malnourished (SAM) children with danger signs of severe pneumonia; however, there is paucity of data on outcome of World Health Organisation (WHO) recommended interventions of SAM children with severe pneumonia. We sought to evaluate outcome of the interventions in such children. Methods We prospectively enrolled SAM children aged 0–59 months, admitted to the Intensive Care Unit (ICU) or Acute Respiratory Infection (ARI) ward of the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), between April 2011 and June 2012 with cough or respiratory difficulty and radiological pneumonia. All the enrolled children were treated with ampicillin and gentamicin, and micronutrients as recommended by the WHO. Comparison was made among pneumonic children with (n = 111) and without WHO defined danger signs of severe pneumonia (n = 296). The outcomes of interest were treatment failure (if a child required changing of antibiotics) and deaths during hospitalization. Further comparison was also made among those who developed treatment failure and who did not and among the survivors and deaths. Results SAM children with danger signs of severe pneumonia more often experienced treatment failure (58% vs. 20%; p<0.001) and fatal outcome (21% vs. 4%; p<0.001) compared to those without danger signs. Only 6/111 (5.4%) SAM children with danger signs of severe pneumonia and 12/296 (4.0%) without danger signs had bacterial isolates from blood. In log-linear binomial regression analysis, after adjusting for potential confounders, danger signs of severe pneumonia, dehydration, hypocalcaemia, and bacteraemia were independently associated both with treatment failure and deaths in SAM children presenting with cough or respiratory difficulty and radiological pneumonia (p<0.01). Conclusion and Significance The result suggests that SAM children with cough or

  17. Using Mid-Upper Arm Circumference to End Treatment of Severe Acute Malnutrition Leads to Higher Weight Gains in the Most Malnourished Children

    PubMed Central

    Dale, Nancy M.; Myatt, Mark; Prudhon, Claudine; Briend, André

    2013-01-01

    Objective The World Health Organization recommends discharging children admitted to nutrition programs treating severe acute malnutrition, with a low mid-upper arm circumference (MUAC <115 mm) when weight gain is >15%. When this recommendation is followed, the most severely malnourished children receive a shorter treatment compared to children that are less severely malnourished. This study assesses whether using MUAC >125 mm as discharge criteria eliminates this effect. Methods and Findings Data from 753 children cured from a Médecins Sans Frontières outpatient nutrition program in Gedaref, North Sudan were analyzed. MUAC >125 mm was used as discharge criteria. Length of stay and percent weight gain of children were compared in relation to nutritional status on admission. Children with low MUAC on admission had a longer duration of treatment (p = 0.000) and also a higher percent weight gain (p = 0.000) than children with higher MUAC. Similar results with weight-for-height z-scores categories were shown with both duration of treatment (p = 0.000) and percent weight gain (p = 0.000). Conclusion This study shows that using MUAC as the discharge criteria eliminates the effect of shorter treatment in most severely malnourished children compared to least severely malnourished, as is observed with percent weight gain. The findings directly address the main concern that has been identified with the current WHO recommendation of using percent weight gain. MUAC could be used as discharge criteria, instead of percent weight gain, as having a longer duration of treatment and a higher percent weight gain for the most malnourished is highly desirable. PMID:23418442

  18. Malnutrition: another health inequality?

    PubMed

    Stratton, Rebecca J

    2007-11-01

    Malnutrition (undernutrition) is one of the many health inequalities facing governments in the 21st century. Malnutrition is a common condition affecting millions of individuals in the UK, particularly older adults, the sick and those cared for within the healthcare system. It costs the National Health Service > pound sterling 7.3 x 109 annually. New data highlight marked geographical differences in the prevalence of malnutrition across England and an inter-relationship between deprivation, malnutrition and poor outcome. As malnutrition is a largely treatable condition, prompt identification and effective prevention and treatment of this costly condition is imperative. Routine screening for malnutrition in high-risk groups (e.g. the elderly and those in areas with high deprivation) and within the healthcare system should be a priority, with screening linked to appropriate plans for the management of malnutrition. Use should be made of specialised interventions, including oral nutritional supplements and artificial nutrition, to aid recovery and improve outcome, with skilled health professionals, including dietitians, involved where possible. Equity of access to nutritional services and treatments for malnutrition needs to occur across the UK and, although complex and multi-factorial, the effects of deprivation and other relevant socio-economic and geographical factors should be addressed. Ultimately, as malnutrition is a public health problem, its identification and treatment must become a priority for governments, healthcare planners and professionals. PMID:17961273

  19. Clinical Risk Factors of Death From Pneumonia in Children with Severe Acute Malnutrition in an Urban Critical Care Ward of Bangladesh

    PubMed Central

    Chisti, Mohammod Jobayer; Salam, Mohammed Abdus; Ashraf, Hasan; Faruque, Abu S. G.; Bardhan, Pradip Kumar; Hossain, Md Iqbal; Shahid, Abu S. M. S. B.; Shahunja, K. M.; Das, Sumon Kumar; Imran, Gazi; Ahmed, Tahmeed

    2013-01-01

    Background Risks of death are high when children with pneumonia also have severe acute malnutrition (SAM) as a co-morbidity. However, there is limited published information on risk factors of death from pneumonia in SAM children. We evaluated clinically identifiable factors associated with death in under-five children who were hospitalized for the management of pneumonia and SAM. Methods For this unmatched case-control design, SAM children of either sex, aged 0–59 months, admitted to the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) during April 2011 to July 2012 with radiological pneumonia were studied. The SAM children with pneumonia who had fatal outcome constituted the cases (n = 35), and randomly selected SAM children with pneumonia who survived constituted controls (n = 105). Results The median (inter-quartile range) age (months) was comparable among the cases and the controls [8.0 (4.9, 11.0) vs. 9.7 (5.0, 18.0); p = 0.210)]. In logistic regression analysis, after adjusting for potential confounders, such as vomiting, abnormal mental status, and systolic hypotension (<70 mm of Hg) in absence of dehydration, fatal cases of severely malnourished under-five children with pneumonia were more often hypoxemic (OR = 23.15, 95% CI = 4.38–122.42), had clinical dehydration (some/severe) (OR = 9.48, 95% CI = 2.42–37.19), abdominal distension at admission (OR = 4.41, 95% CI = 1.12–16.52), and received blood transfusion (OR = 5.50, 95% CI = 1.21–24.99) for the management of crystalloid resistant systolic hypotension. Conclusion and Significance We identified hypoxemia, clinical dehydration, and abdominal distension as the independent predictors of death in SAM children with pneumonia. SAM children with pneumonia who required blood transfusion for the management of crystalloid resistant systolic hypotension were also at risk for death. Thus, early identification and

  20. Malnutrition, Learning, and Behavior.

    ERIC Educational Resources Information Center

    Kallen, David J.

    Malnutrition can be defined as a lack of a sufficient quantity or quality of nutrients to maintain the body system at some definable level of functioning. It has been estimated that nearly half the children in the world today grow and develop under conditions of protein or protein-calorie malnutrition sufficient to impair their physical…

  1. Malnutrition, Learning, and Behavior.

    ERIC Educational Resources Information Center

    Read, Merrill S.; Felson, David

    The problems of those children who are chronically malnourished, the cultural environment of malnutrition, and the extent to which children are temporarily or permanently handicapped in learning because of malnutrition are discussed in this booklet. It also describes hunger and its effects on child development. The topics addressed are: definition…

  2. Malnutrition among the elderly.

    PubMed Central

    Rauscher, C.

    1993-01-01

    Nutrition is a significant determinant of health. Undernutrition presenting as malnutrition is a serious health concern for frail elderly people with many health problems. Understanding the risk factors for malnutrition helps physicians assess and manage the condition. Primary care physicians are in an excellent position to screen, educate, and manage their elderly malnourished patients. Images p1396-a PMID:8324408

  3. Infant malnutrition in Indonesia

    PubMed Central

    Oomen, H. A. P. C.

    1953-01-01

    Infant malnutrition, resulting frequently in the death of children of pre-school age, is a problem requiring urgent solution in Indonesia. Children suffering from malnutrition show a variety of symptoms, the most characteristic being emaciation, growth retardation, liver changes, dyspigmentation of skin and hair, other skin lesions, oedema, muscular wasting, anaemia, and xerophthalmia. The indicative value of xerophthalmia, which often leads to the development of keratomalacia, in the diagnosis of malnutrition is stressed by the author. Further research is required to determine the causes—and particularly the part played by diet—of the clinical differences observed in malnutrition cases. Far greater interest in the problem of malnutrition must be shown by the entire medical profession in Indonesia if treatment is to be carried out successfully. The specific symptom, xerophthalmia, is easily curable with cod-liver oil. General malnutrition can be prevented only if sufficient amounts, both quantitatively and qualitatively, of protein, vitamin A, and calories are provided for every child. The Indonesian must be taught, by practical example, the necessity of adequate feeding, and be encouraged to make maximum use of locally available foods. It is hoped that the centres to deal with malnutrition, envisaged by the Ministry of Health, will provide both curative and preventive treatment and facilities for propaganda and research. ImagesFIG. 1-2FIG. 3-4FIG. 5-6FIG. 7FIG. 8 PMID:13106702

  4. Malnutrition and Learning

    ERIC Educational Resources Information Center

    Shneour, Elie A.; Shneour, Joan B.

    1977-01-01

    Explores the relationships between nutrition, stimulation, brain development, and learning. Consequences of malnutrition on learning include loss of learning time, interference with learning during critical periods of development, and motivation and personality changes. (Author/DB)

  5. Malnutrition and ageing.

    PubMed

    Hickson, M

    2006-01-01

    This article aims to provide an overview of the problems that exist in relation to malnutrition and the elderly population. The changes that occur in body composition during ageing are described and how this may affect disease risk. The possible metabolic processes behind weight loss are discussed and the numerous factors that affect nutritional status in the older age group are described. Prevention of malnutrition in this group is important and so the roles of nutrition screening and assessment are examined. PMID:16397072

  6. Pediatric Malnutrition: Putting the New Definition and Standards Into Practice.

    PubMed

    Beer, Stacey S; Juarez, Marisa D; Vega, Molly W; Canada, Nicki L

    2015-10-01

    In recent years, much effort has been directed at redefining malnutrition in the pediatric population to include the acute clinical population in addition to the more traditional ambulatory populations. In 2013, an expert panel convened to perform a critical review of available literature to craft a new approach to malnutrition. Closely thereafter, the Academy of Nutrition and Dietetics and the American Society for Parenteral and Enteral Nutrition published recommended indicators for the identification and documentation of malnutrition in pediatric populations. The purpose of this article is to review the domains within the new definition of malnutrition in pediatric practice, describe populations in which the recommended indicators for identification and management are problematic in clinical practice, give case studies that apply the new definition, and finally describe the implementation of a malnutrition identification program within a large tertiary care children's hospital. PMID:26330113

  7. Host response, malnutrition and oral diseases. Part 2

    PubMed Central

    Słotwiński, Robert

    2014-01-01

    Acute phase proteins enhance antioxidant defenses; they are involved in the activation of complement components, opsonization and increase in platelet aggregation as well as inhibition of the respiratory burst in the course of inflammation. Malnutrition plays an important role in the course of response of acute phase proteins. The role of nutrients as antioxidants or as key components of antioxidant enzymes is commonly known. In the course of various inflammatory states, including oral diseases, disorders are observed in caloric requirements of the organism and the requirements for specific amino acids. Numerous experimental studies in animals have also confirmed the relationship between protein- calorie malnutrition and hypofunction of the salivary glands. Studies in children with malnutrition syndrome showed a significantly lower volume of saliva compared to properly nourished children. Depleted nutritional reserves due to long-term chronic malnutrition cause a significant reduction in resistance, progressive damage to the oral mucosa, and reduce resistance to colonization and invasion of pathogenic microorganisms. PMID:26155173

  8. [Cancer and Malnutrition].

    PubMed

    Tsuzuki, Norimasa; Higashiguchi, Takashi; Ito, Akihiro; Ohara, Hiroshi; Futamura, Akihiko

    2015-07-01

    A Japanese proverb says that a balanced diet leads to a healthy body. However, the relation between healthy life and nutrition has not been established precisely and quantitatively. Cancer cachexia, which is malnutrition in cancer patients, has been studied extensively. Appropriate nutrition support can prevent the progression of malnutrition in cancer patients and advance the tolerance for anticancer therapy. In refractory cachexia (terminally cancer patients), we will judge the necessity of reduction of nutrition support, what it is called "gear-change", because the support is burden for the body. It is important to restrict the quantity of nutrition and to give medical treatment to retain bodily function in these patients. PMID:26197740

  9. mamO and mamE genes are essential for magnetosome crystal biomineralization in Magnetospirillum gryphiswaldense MSR-1.

    PubMed

    Yang, Wei; Li, Ruiguo; Peng, Tao; Zhang, Yang; Jiang, Wei; Li, Ying; Li, Jilun

    2010-10-01

    Four non-magnetic mutants of Magnetospirillum gryphiswaldense strain MSR-1 were isolated by transposon mutagenesis and found to contain interruption of either the mamO or mamE gene within the mamAB operon. Studies indicated that mamO and mamE genes are essential for magnetosome crystal biomineralization in MSR-1. This is the first report of a single gene (mamO or mamE) whose mutation affects crystal biomineralization in MSR-1. PMID:20674739

  10. Severe Malnutrition: A Global Approach.

    ERIC Educational Resources Information Center

    Pelletier, Jean-Gerard

    1993-01-01

    This report examines the immediate and underlying causes of malnutrition in the developing world. The first section discusses the effects of malnutrition on childhood development and examines the efficacy of nutritional rehabilitation. The second section addresses the medical effects of severe malnutrition, including the onset of ponderostatural…

  11. Proteomic Analysis of Mitochondrial-Associated ER Membranes (MAM) during RNA Virus Infection Reveals Dynamic Changes in Protein and Organelle Trafficking

    PubMed Central

    Horner, Stacy M.; Wilkins, Courtney; Badil, Samantha; Iskarpatyoti, Jason; Gale, Michael

    2015-01-01

    RIG-I pathway signaling of innate immunity against RNA virus infection is organized between the ER and mitochondria on a subdomain of the ER called the mitochondrial-associated ER membrane (MAM). The RIG-I adaptor protein MAVS transmits downstream signaling of antiviral immunity, with signaling complexes assembling on the MAM in association with mitochondria and peroxisomes. To identify components that regulate MAVS signalosome assembly on the MAM, we characterized the proteome of MAM, ER, and cytosol from cells infected with either chronic (hepatitis C) or acute (Sendai) RNA virus infections, as well as mock-infected cells. Comparative analysis of protein trafficking dynamics during both chronic and acute viral infection reveals differential protein profiles in the MAM during RIG-I pathway activation. We identified proteins and biochemical pathways recruited into and out of the MAM in both chronic and acute RNA viral infections, representing proteins that drive immunity and/or regulate viral replication. In addition, by using this comparative proteomics approach, we identified 3 new MAVS-interacting proteins, RAB1B, VTN, and LONP1, and defined LONP1 as a positive regulator of the RIG-I pathway. Our proteomic analysis also reveals a dynamic cross-talk between subcellular compartments during both acute and chronic RNA virus infection, and demonstrates the importance of the MAM as a central platform that coordinates innate immune signaling to initiate immunity against RNA virus infection. PMID:25734423

  12. Malnutrition and Learning.

    ERIC Educational Resources Information Center

    Bakan, Rita

    The characteristics of malnourished children bear a striking resemblance to a number of the known characteristics of "disadvantaged children," e.g. apathy, irritability, sickliness, and a reduced attention span. The combination of malnutrition and the other negative effects of poverty perpetuates a cycle of illness, educational failure, and more…

  13. Malnutrition and Psychological Development.

    ERIC Educational Resources Information Center

    Ricciuti, Henry N.

    What is the status of our present knowledge concerning the influence of malnutrition on intellectual development, learning, and behavior in children? This paper focuses primarily on an identification of some of the major issues and questions which are of concern to investigators in the field. The major concern of this review is with…

  14. Childhood Malnutrition and the Intestinal Microbiome Malnutrition and the microbiome

    PubMed Central

    Kane, Anne V.; Dinh, Duy M.; Ward, Honorine D.

    2015-01-01

    Malnutrition contributes to almost half of all deaths in children under the age of 5 years, particularly those who live in resource-constrained areas. Those who survive frequently suffer from long-term sequelae including growth failure and neurodevelopmental impairment. Malnutrition is part of a vicious cycle of impaired immunity, recurrent infections and worsening malnutrition. Recently, alterations in the gut microbiome have also been strongly implicated in childhood malnutrition. It has been suggested that malnutrition may delay the normal development of the gut microbiota in early childhood or force it towards an altered composition that lacks the required functions for healthy growth and/or increases the risk for intestinal inflammation. This review addresses our current understanding of the beneficial contributions of gut microbiota to human nutrition (and conversely the potential role of changes in that community to malnutrition), the process of acquiring an intestinal microbiome, potential influences of malnutrition on the developing microbiota and the evidence directly linking alterations in the intestinal microbiome to childhood malnutrition. We review recent studies on the association between alterations in the intestinal microbiome and early childhood malnutrition and discuss them in the context of implications for intervention or prevention of the devastation caused by malnutrition. PMID:25356748

  15. Malnutrition and the heart.

    PubMed Central

    Webb, J G; Kiess, M C; Chan-Yan, C C

    1986-01-01

    Earlier concepts that the heart is spared in malnutrition have been shown to be incorrect. Inadequate intake of protein and energy results in proportional loss of skeletal and myocardial muscle. As myocardial mass decreases, so does the ability to generate cardiac output; however, various compensatory factors come into play. Nutritional supplementation for malnourished patients reverses the compensatory factors and may increase the short-term potential for heart failure. Severe cardiac debility results in poor nutrition, which may in turn produce unsuspected but clinically significant myocardial atrophy. Nutritional support may play a role in improving cardiac function in selected patients with cardiac cachexia who are being prepared for cardiac surgery and in patients with rapid weight loss who are at risk for sudden death due to arrhythmias. Malnutrition is common in hospitalized patients, and many patients in hospital now receive nutritional supplementation; both facts have important cardiac implications. PMID:3093042

  16. Malnutrition and micronutrient deficiencies among Bhutanese refugee children--Nepal, 2007.

    PubMed

    2008-04-11

    Acute and chronic malnutrition and micronutrient deficiencies have been found in refugee camp populations. In southeastern Nepal, despite consistent access by refugees to general rations, certain micronutrient deficiencies have posed a substantial health burden to the approximately 100,000 Bhutanese residing in seven refugee camps. Limited food diversity, frequent illness, and poor feeding practices have been cited as underlying causes of poor nutritional status in this population. Annual surveys to assess levels of acute malnutrition (i.e., wasting) and chronic malnutrition (i.e., stunting) have been conducted in these camps by the Association of Medical Doctors of Asia (AMDA) and United Nations High Commissioner for Refugees (UNHCR); however, the capacity to reliably evaluate micronutrient deficiencies has not existed locally in the camps. In January 2007, AMDA and CDC, at the request of UNHCR and the World Food Programme (WFP), conducted a nutritional survey of children aged 6-59 months, assessing 1) the prevalence of acute malnutrition, chronic malnutrition, underweight, anemia, and angular stomatitis (i.e., riboflavin deficiency); 2) the cumulative incidence of diarrhea and acute respiratory illness (ARI); and 3) the feeding practices of the children's mothers. This report describes the results of that survey, which indicated that, although acute malnutrition was found in only 4.2% of the children, chronic malnutrition was found in 26.9% and anemia in 43.3%. These findings underscore the importance of monitoring both malnutrition and micronutrient deficiencies and addressing the underlying causes of nutritional deficits. PMID:18401331

  17. Warts, malnutrition, and sunshine.

    PubMed

    Orozco-Topete, Rocío; Villa, Antonio; Leyva Santiago, Jaime; Scholtes, Christian; Archer-Dubon, Carla; Ysunza, Alberto

    2008-01-01

    Viral warts are common in poor rural settings but their relationship to malnutrition has not been studied. We sought to determine the prevalence of warts in children of two communities in Oaxaca, Mexico, and compared it with their nutritional status. Children from Santa Catarina Yahuio and Santiago Laxopa of the state of Oaxaca were examined. Localization, number, and type of verruca were noted. Date of birth, height, and weight were obtained to determine nutritional status. A total of 213 children (116 girls and 97 boys), 107 in Yahuio and 106 in Laxopa, were studied. Mean age was 10.24 years. Thirty children (14.1%) had warts and 80% (24/30) of these lived in Yahuio (p = 0.0002). Almost half were teenagers. Most lesions were on sun-exposed areas. First degree malnutrition was found in 24.5%; second degree in 23.6% and third degree in 14.2%. A higher frequency of warts than previously reported was found. Malnutrition was prevalent in both groups but did not correlate positively with verruca. Verruca were more frequent in females, adolescents, sun-exposed areas, and higher altitude. We believe that the higher altitude of Yahuio facilitates greater exposure to ultraviolet light-induced immune suppression. PMID:18577057

  18. The Graz Malnutrition Screening (GMS): a new hospital screening tool for malnutrition.

    PubMed

    Roller, Regina E; Eglseer, Doris; Eisenberger, Anna; Wirnsberger, Gerhard H

    2016-02-28

    Despite the significant impact of malnutrition in hospitalised patients, it is often not identified by clinical staff in daily practice. To improve nutritional support in hospitals, standardised routine nutritional screening is essential. The Graz Malnutrition Screening (GMS) tool was developed for the purpose of malnutrition risk screening in a large hospital setting involving different departments. It was the aim of the present study to validate the GMS against Nutritional Risk Screening (NRS) and Mini Nutritional Assessment-short form (MNA-sf) in a randomised blinded manner. A total of 404 randomly selected patients admitted to the internal, surgical and orthopaedic wards of the University Hospital Graz were screened in a blinded manner by different raters. Concurrent validity was determined by comparing the GMS with the NRS and in older patients (70+ years) with the MNA-sf additionally. According to GMS, 31·9 or 28·5% of the admitted patients were categorised as at 'risk of malnutrition' (depending on the rater). According to the reference standard of NRS, 24·5% of the patients suffered from malnutrition. Pearson's r values of 0·78 compared with the NRS and 0·84 compared with the MNA showed strong positive correlations. Results of accuracy (0·85), sensitivity (0·94), specificity (0·77), positive predictive value (0·76) and negative predictive value (0·95) of GMS were also very high. Cohen's κ for internal consistency of the GMS was 0·82. GMS proves to be a valid and reliable instrument for the detection of malnutrition in adult patients in acute-care hospitals. PMID:26652856

  19. Alcoholic liver disease and malnutrition.

    PubMed

    McClain, Craig J; Barve, Shirish S; Barve, Ashutosh; Marsano, Luis

    2011-05-01

    Malnutrition, both protein energy malnutrition (PEM) and deficiencies in individual nutrients, is a frequent complication of alcoholic liver disease (ALD). Severity of malnutrition correlates with severity of ALD. Malnutrition also occurs in patients with cirrhosis due to etiologies other than alcohol. The mechanisms for malnutrition are multifactorial, and malnutrition frequently worsens in the hospital due to fasting for procedures and metabolic complications of liver disease, such as hepatic encephalopathy. Aggressive nutritional support is indicated in inpatients with ALD, and patients often need to be fed through an enteral feeding tube to achieve protein and calorie goals. Enteral nutritional support clearly improves nutrition status and may improve clinical outcome. Moreover, late-night snacks in outpatient cirrhotics improve nutritional status and lean body mass. Thus, with no FDA-approved therapy for ALD, careful nutritional intervention should be considered as frontline therapy. PMID:21284673

  20. Alcoholic Liver Disease and Malnutrition

    PubMed Central

    McClain, Craig J.; Barve, Shirish S.; Barve, Ashutosh; Marsano, Luis

    2013-01-01

    Malnutrition, both protein energy malnutrition (PEM) and deficiencies in individual nutrients, is a frequent complication of alcoholic liver disease (ALD). Severity of malnutrition correlates with severity of ALD. Malnutrition also occurs in patients with cirrhosis due to etiologies other than alcohol. The mechanisms for malnutrition are multifactorial, and malnutrition frequently worsens in the hospital due to fasting for procedures and metabolic complications of liver disease, such as hepatic encephalopathy. Aggressive nutritional support is indicated in inpatients with ALD, and patients often need to be fed through an enteral feeding tube to achieve protein and calorie goals. Enteral nutritional support clearly improves nutrition status and may improve clinical outcome. Moreover, late-night snacks in outpatient cirrhotics improve nutritional status and lean body mass. Thus, with no FDA-approved therapy for ALD, careful nutritional intervention should be considered as frontline therapy. PMID:21284673

  1. Screening for Malnutrition in Older People.

    PubMed

    Guyonnet, Sophie; Rolland, Yves

    2015-08-01

    Malnutrition risk increases with age and level of care. Despite significant medical advances, malnutrition remains a significant and highly prevalent public health problem of developed countries. Earlier identification and appropriate nutrition support may help to reverse or halt the malnutrition trajectory and the negative outcomes associated with poor nutritional status. A nutrition screening process is recommended to help detect people with protein-energy malnutrition (PEM) or at malnutrition risk. Evidence supports that oral nutritional supplements and dietary counseling can increase dietary intake and improve quality of life in elderly with PEM or at malnutrition risk. This article examines nutritional screening and assessment tools designated for older adults. PMID:26195101

  2. Malnutrition: A Deterrent to Human Progress

    ERIC Educational Resources Information Center

    Johnson, Nancy E.; Found, R. Elaine

    1971-01-01

    Authors discuss the effects of malnutrition on retardation of mental development and intellectual capacity. Research findings on undernourished experimental animals are cited as well as studies involving children suffering the effects of malnutrition in infancy. (Editor/LF)

  3. Malnutrition: The Wasting of Human Potential.

    ERIC Educational Resources Information Center

    Taylor, Patricia S.

    The paper discusses the prevalence of malnutrition in developing countries and the United States, particularly as it relates to debilitating physical and psychological disorders. Educational, social, and political factors which influence the cycle of malnutrition are described. Research on the relationship between malnutrition and intellectual…

  4. Infant Malnutrition: Shame of our Nation

    ERIC Educational Resources Information Center

    Low, Merritt Burnham

    1975-01-01

    Argues that severe infant malnutrition is shockingly widespread in the United States, that the effects of malnutrition in infancy are now recognized to be much more devastating than had hitherto been known, and that the probable relationship between poverty, malnutrition, and mental deficiency is far too strong to overlook. [Available from…

  5. Identifying and managing malnutrition in the community.

    PubMed

    McEvilly, Aimee

    2016-01-01

    Malnutrition affects more than 3 million people in the UK, most of whom live in the community. Malnutrition is both a cause and consequence of disease and can lead to increased mortality and morbidity, delayed recovery from illness and impaired body function which can make carrying out activities of daily living difficult. Managing malnutrition in the community involves identifying malnutrition using a universally validated screening tool and implementing appropriate care plans according to the degree of malnutrition. Regional and local guidance can be used to assist healthcare professionals to prescribe appropriate oral nutritional supplements and monitor nutritional aims and goals. PMID:27396860

  6. Wildfire and MAMS data from STORMFEST

    NASA Technical Reports Server (NTRS)

    Jedlovec, Gary J.; Carlson, G. S.

    1993-01-01

    Early in 1992, NASA participated in an inter-agency field program called STORMFEST. The STORM-Fronts Experiment Systems Test (STORMFEST) was designed to test various systems critical to the success of STORM 1 in a very focused experiment. The field effort focused on winter storms in order to investigate the structure and evolution of fronts and associated mesoscale phenomena in the central United States. This document describes the data collected from two instruments onboard a NASA ER2 aircraft which was deployed out of Ellington Field in Houston, Texas from February 13 through March 15, 1992, in support of this experiment. The two instruments were the Wildfire (a.k.a. the moderate resolution imaging spectrometer-nadir (MODIS-N) Airborne Simulation (MAS)) and the Multispectral Atmospheric Mapping Sensor (MAMS).

  7. Malnutrition and its oral outcome - a review.

    PubMed

    Sheetal, Aparna; Hiremath, Vinay Kumar; Patil, Anand G; Sajjansetty, Sangmeshwar; Kumar, Sheetal R

    2013-01-01

    Malnutrition affects the oral health and a poor oral health in turn, may lead to malnutrition. This interdependent relationship sees good nutritional health, thus promoting good oral health and vice versa. Malnutrition may alter the homeostasis, which can lead to disease progression of the oral cavity, reduce the resistance to the microbial biofilm and reduce the capacity of tissue healing. It may even affect the development of the oral cavity. Protein-energy malnutrition occurs when there is a deficiency of protein, energy foods or both, which are relative to a body's need. Studies have suggested that enamel hypoplasia, salivary gland hypofunction and saliva compositional changes may be the mechanisms through which the malnutrition is associated with caries, while an altered eruption timing may create a challenge in the analysis of the age specific caries rates. This paper gives an insight on the relationship of the malnutrition and the protein-energy malnutrition with the oral health status. PMID:23449967

  8. Prevalence and assessment of malnutrition risk among hospitalized children in Romania.

    PubMed

    Mărginean, Oana; Pitea, Ana Maria; Voidăzan, Septimiu; Mărginean, Claudiu

    2014-03-01

    Malnutrition is a prevalent condition in hospitalized children. Our aims were to evaluate the nutritional state and to validate the STRONGkids risk assessment tool in a hospitalized paediatric population in Romania. This is a prospective single-centre study in a tertiary teaching hospital in Romania (May 2011-January 2012). We calculated the STRONGkids score and measured the children's height and weight. Standard deviation < -2 for weight-for-height and height-for-age was considered to indicate acute or chronic malnutrition respectively. Two hundred seventy-one children were included, with median age of 5.2 years and median hospital stay of 2.01 days. Prevalence of malnutrition and severe malnutrition was 37% and 15% respectively. Using the STRONGkids screening tool, 58% of the children were found at risk of malnutrition (24% were at high risk). The kappa coefficient of agreement between STRONGkids and WHO malnutrition classification was 0.61. When a low serum protein level was used in upgrading STRONGkids risk category, kappa increased significantly to 0.71 (p = 0.001). A modified STRONGkids score, incorporating total serum protein levels, performs well in predicting malnutrition in hospitalized paediatric population in Romania. PMID:24847598

  9. [Malnutrition screening in clinical practice].

    PubMed

    Hankard, R; Colomb, V; Piloquet, H; Bocquet, A; Bresson, J-L; Briend, A; Chouraqui, J-P; Darmaun, D; Dupont, C; Frelut, M-L; Girardet, J-P; Goulet, O; Rieu, D; Simeoni, U; Turck, D; Vidailhet, M

    2012-10-01

    Protein energy malnutrition (PEM) occurs when energy and protein intake do not meet requirements. It has a functional and structural impact and increases both morbidity and mortality of a given disease. The Nutrition Committee of the French Pediatric Society recommends weighing and measuring any child when hospitalized or seen in consultation. The body mass index (BMI) must be calculated and analyzed according to references any time growth kinetics cannot be analyzed. Any child with a BMI below the third centile or -2 standard deviations for age and sex needs to be examined looking for clinical signs of malnutrition and signs orienting toward an etiology and requires having his BMI and height dynamics plotted on a chart. PEM warrants drawing up a nutritional strategy along with the overall care plan. A target weight needs to be determined as well as the quantitative and qualitative nutritional care including its implementation. This plan must be evaluated afterwards in order to adapt the nutritional therapy. PMID:22959889

  10. Malnutrition as an underlying cause of childhood deaths associated with infectious diseases in developing countries.

    PubMed Central

    Rice, A. L.; Sacco, L.; Hyder, A.; Black, R. E.

    2000-01-01

    INTRODUCTION: Recent estimates suggest that malnutrition (measured as poor anthropometric status) is associated with about 50% of all deaths among children. Although the association between malnutrition and all-cause mortality is well documented, the malnutrition-related risk of death associated with specific diseases is less well described. We reviewed published literature to examine the evidence for a relation between malnutrition and child mortality from diarrhoea, acute respiratory illness, malaria and measles, conditions that account for over 50% of deaths in children worldwide. METHODS: MEDLINE was searched for suitable review articles and original reports of community-based and hospital-based studies. Findings from cohort studies and case-control studies were reviewed and summarized. RESULTS: The strongest and most consistent relation between malnutrition and an increased risk of death was observed for diarrhoea and acute respiratory infection. The evidence, although limited, also suggests a potentially increased risk for death from malaria. A less consistent association was observed between nutritional status and death from measles. Although some hospital-based studies and case-control studies reported an increased risk of mortality from measles, few community-based studies reported any association. DISCUSSION: The risk of malnutrition-related mortality seems to vary for different diseases. These findings have important implications for the evaluation of nutritional intervention programmes and child survival programmes being implemented in settings with different disease profiles. PMID:11100616

  11. Malnutrition induces gut atrophy and increases hepatic fat infiltration: studies in a pig model of childhood malnutrition

    PubMed Central

    Lykke, Mikkel; Hother, Anne-Louise; Hansen, Christian F; Friis, Henrik; Mølgaard, Christian; Michaelsen, Kim F; Briend, André; Larsen, Torben; Sangild, Per T; Thymann, Thomas

    2013-01-01

    Childhood malnutrition is a problem in developing countries, and pathological changes in digestive organs such as the intestine and liver are poorly understood. An animal model to study the progression of severe acute malnutrition could elucidate pathological changes in the intestine and liver. We sought to characterize growth and clinical changes during malnutrition related to structural and functional indices in the intestine and liver. Newly weaned piglets were given ad libitum access to a maize flour diet (MAIZE, n=9) or a nutritionally optimized reference diet (REFERENCE, n=12) for 7 weeks. Growth, hematology and clinical biochemistry where recorded weekly. After 7 weeks, the MAIZE pigs had lower body weights than the REF pigs (8.3 kg vs. 32.4 kg, P < 0.001), indicating severe stunting and moderate to severe wasting. This was paralleled by lower values for hematocrit, hemoglobin and mean cell volume in MAIZE vs. REFERENCE (P < 0.01), indicating anemia. Although the observed temporal changes in MAIZE were associated with atrophy of the small intestinal mucosa (P < 0.001), digestive enzyme activity was only marginally reduced. Serum alanine aminotransferase, bilirubin and albumin were increased in the MAIZE pigs (P < 0.001), and the liver had a vacuolated appearance and tendency toward increased triglyceride content (P=0.054). We conclude that liver and intestinal indices are compromised during malnutrition and are associated with temporal changes in growth and hematological and biochemical endpoints. The pig model is relevant for malnourished infants and can act as a valuable tool for understanding the pathophysiology of malnutrition. PMID:23977413

  12. Interplay between Two Bacterial Actin Homologs, MamK and MamK-Like, Is Required for the Alignment of Magnetosome Organelles in Magnetospirillum magneticum AMB-1

    PubMed Central

    Abreu, Nicole; Mannoubi, Soumaya; Ozyamak, Ertan; Pignol, David; Ginet, Nicolas

    2014-01-01

    Many bacterial species contain multiple actin-like proteins tasked with the execution of crucial cell biological functions. MamK, an actin-like protein found in magnetotactic bacteria, is important in organizing magnetosome organelles into chains that are used for navigation along geomagnetic fields. MamK and numerous other magnetosome formation factors are encoded by a genetic island termed the magnetosome island. Unlike most magnetotactic bacteria, Magnetospirillum magneticum AMB-1 (AMB-1) contains a second island of magnetosome-related genes that was named the magnetosome islet. A homologous copy of mamK, mamK-like, resides within this islet and encodes a protein capable of filament formation in vitro. Previous work had shown that mamK-like is expressed in vivo, but its function, if any, had remained unknown. Though MamK-like is highly similar to MamK, it contains a mutation that in MamK and other actins blocks ATPase activity in vitro and filament dynamics in vivo. Here, using genetic analysis, we demonstrate that mamK-like has an in vivo role in assisting organelle alignment. In addition, MamK-like forms filaments in vivo in a manner that is dependent on the presence of MamK and the two proteins interact in a yeast two-hybrid assay. Surprisingly, despite the ATPase active-site mutation, MamK-like is capable of ATP hydrolysis in vitro and promotes MamK filament turnover in vivo. Taken together, these experiments suggest that direct interactions between MamK and MamK-like contribute to magnetosome alignment in AMB-1. PMID:24957623

  13. Interplay between two bacterial actin homologs, MamK and MamK-Like, is required for the alignment of magnetosome organelles in Magnetospirillum magneticum AMB-1.

    PubMed

    Abreu, Nicole; Mannoubi, Soumaya; Ozyamak, Ertan; Pignol, David; Ginet, Nicolas; Komeili, Arash

    2014-09-01

    Many bacterial species contain multiple actin-like proteins tasked with the execution of crucial cell biological functions. MamK, an actin-like protein found in magnetotactic bacteria, is important in organizing magnetosome organelles into chains that are used for navigation along geomagnetic fields. MamK and numerous other magnetosome formation factors are encoded by a genetic island termed the magnetosome island. Unlike most magnetotactic bacteria, Magnetospirillum magneticum AMB-1 (AMB-1) contains a second island of magnetosome-related genes that was named the magnetosome islet. A homologous copy of mamK, mamK-like, resides within this islet and encodes a protein capable of filament formation in vitro. Previous work had shown that mamK-like is expressed in vivo, but its function, if any, had remained unknown. Though MamK-like is highly similar to MamK, it contains a mutation that in MamK and other actins blocks ATPase activity in vitro and filament dynamics in vivo. Here, using genetic analysis, we demonstrate that mamK-like has an in vivo role in assisting organelle alignment. In addition, MamK-like forms filaments in vivo in a manner that is dependent on the presence of MamK and the two proteins interact in a yeast two-hybrid assay. Surprisingly, despite the ATPase active-site mutation, MamK-like is capable of ATP hydrolysis in vitro and promotes MamK filament turnover in vivo. Taken together, these experiments suggest that direct interactions between MamK and MamK-like contribute to magnetosome alignment in AMB-1. PMID:24957623

  14. Malnutrition

    MedlinePlus

    ... diet Starvation due to food not being available Eating disorders Problems with digesting food or absorbing nutrients from ... B9 (folacin) Deficiency - Vitamin E Deficiency - Vitamin K Eating disorders Kwashiorkor Megaloblastic anemia Pellagra Rickets Scurvy Spina bifida ...

  15. Hospital Malnutrition: Prevalence, Identification and Impact on Patients and the Healthcare System

    PubMed Central

    Barker, Lisa A.; Gout, Belinda S.; Crowe, Timothy C.

    2011-01-01

    Malnutrition is a debilitating and highly prevalent condition in the acute hospital setting, with Australian and international studies reporting rates of approximately 40%. Malnutrition is associated with many adverse outcomes including depression of the immune system, impaired wound healing, muscle wasting, longer lengths of hospital stay, higher treatment costs and increased mortality. Referral rates for dietetic assessment and treatment of malnourished patients have proven to be suboptimal, thereby increasing the likelihood of developing such aforementioned complications. Nutrition risk screening using a validated tool is a simple technique to rapidly identify patients at risk of malnutrition, and provides a basis for prompt dietetic referrals. In Australia, nutrition screening upon hospital admission is not mandatory, which is of concern knowing that malnutrition remains under-reported and often poorly documented. Unidentified malnutrition not only heightens the risk of adverse complications for patients, but can potentially result in foregone reimbursements to the hospital through casemix-based funding schemes. It is strongly recommended that mandatory nutrition screening be widely adopted in line with published best-practice guidelines to effectively target and reduce the incidence of hospital malnutrition. PMID:21556200

  16. Early Malnutrition and Central Nervous System Function

    ERIC Educational Resources Information Center

    Scrimshaw, Nevin S.

    1969-01-01

    Discusses the consequences of severe malnutrition in young experimental animals. Development of the brain is permanently impaired. Studies of the effects of malnutrition on children are included. (This paper was presented at the Eighth Annual Lecture of the Merrill-Palmer Historical Library in Child Development and Family Life, October 25, 1968.)…

  17. Identifying Protein-Calorie Malnutrition Workshop.

    ERIC Educational Resources Information Center

    Walker, Susan S.; Barker, Ellen M.

    Instructional materials are provided for a workshop to enable participants to assist in identifying patients at risk with protein-calorie malnutrition and in corrrecting this nutritional deficiency. Representative topics are nutrients; protein, mineral, and vitamin sources, functions, and deficiency symptoms; malnutrition; nutritional deficiency…

  18. High-oleic ready-to-use therapeutic food maintains docosahexaenoic acid status in severe malnutrition

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Ready-to-use therapeutic food (RUTF) is the preferred treatment for uncomplicated severe acute malnutrition. It contains large amounts of linoleic acid and little a-linolenic acid, which may reduce the availability of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) to the recovering child...

  19. Establishment of the BacMam system using silkworm baculovirus.

    PubMed

    Imai, Atsutoshi; Tadokoro, Takashi; Kita, Shunsuke; Horiuchi, Masataka; Fukuhara, Hideo; Maenaka, Katsumi

    2016-09-16

    The BacMam system uses modified insect viruses (baculoviruses) as vehicles to efficiently deliver genes for expression in mammalian cells. The technique can be widely applied to large-scale recombinant protein production with appropriate modifications, high-throughput screening platforms for cell-based assays, and the delivery of large genes. The silkworm system is often employed as a rapid and cost-effective approach for recombinant baculovirus generation. Here we have developed the novel BacMam system using silkworm baculovirus, and shown the successful expression of EGFP in mammalian cells. The transduction to mammalian cells via the BacMam system was improved by adding phosphate-buffered saline and sodium butyrate to the culture medium and lowering the temperature after viral infection. This study provides an alternative gene delivery system for mammalian cells, which has various potential applications, including efficient native protein production and gene therapy. PMID:27480929

  20. Improved capabilities of the Multispectral Atmospheric Mapping Sensor (MAMS)

    NASA Technical Reports Server (NTRS)

    Jedlovec, Gary J.; Batson, K. Bryan; Atkinson, Robert J.; Moeller, Chris C.; Menzel, W. Paul; James, Mark W.

    1989-01-01

    The Multispectral Atmospheric Mapping Sensor (MAMS) is an airborne instrument being investigated as part of NASA's high altitude research program. Findings from work on this and other instruments have been important as the scientific justification of new instrumentation for the Earth Observing System (EOS). This report discusses changes to the instrument which have led to new capabilities, improved data quality, and more accurate calibration methods. In order to provide a summary of the data collected with MAMS, a complete list of flight dates and locations is provided. For many applications, registration of MAMS imagery with landmarks is required. The navigation of this data on the Man-computer Interactive Data Access System (McIDAS) is discussed. Finally, research applications of the data are discussed and specific examples are presented to show the applicability of these measurements to NASA's Earth System Science (ESS) objectives.

  1. Microgravity Acceleration Measurement System (MAMS) Flight Configuration Verification and Status

    NASA Technical Reports Server (NTRS)

    Wagar, William

    2000-01-01

    The Microgravity Acceleration Measurement System (MAMS) is a precision spaceflight instrument designed to measure and characterize the microgravity environment existing in the US Lab Module of the International Space Station. Both vibratory and quasi-steady triaxial acceleration data are acquired and provided to an Ethernet data link. The MAMS Double Mid-Deck Locker (DMDL) EXPRESS Rack payload meets all the ISS IDD and ICD interface requirements as discussed in the paper which also presents flight configuration illustrations. The overall MAMS sensor and data acquisition performance and verification data are presented in addition to a discussion of the Command and Data Handling features implemented via the ISS, downlink and the GRC Telescience Center displays.

  2. MamX encoded by the mamXY operon is involved in control of magnetosome maturation in Magnetospirillum gryphiswaldense MSR-1

    PubMed Central

    2013-01-01

    Background Magnetotactic bacteria produce membrane-enveloped magnetite crystals (magnetosomes) whose formation is controlled primarily by a gene island termed the magnetosome island (MAI). Characterization of single gene and operon function in MAI has elucidated in part the genetic basis of magnetosome formation. The mamX gene, located in the mamXY operon, is highly conserved in the MAI of all Magnetospirillum strains studied to date. Little is known regarding the function of mamX in the process of biomineralization. Results A mamX deletion mutant (∆mamX) and its complemented strain (CmamX) by conjugation in M. gryphiswaldense strain MSR-1 were constructed. There were no striking differences in cell growth among ∆mamX, CmamX, and wild-type strain (WT). ∆mamX displayed a much weaker magnetic response than WT. Transmission electron microscopy revealed the presence of irregular, superparamagnetic magnetite particles in ∆mamX, in contrast to regular, single-domain particles in WT and CmamX. The phenotype of ∆mamX was similar to that of an ftsZ-like deleted mutant and mamXY operon deleted mutant reported previously. Quantitative real-time RT-PCR (qPCR) results indicated that the deletion of mamX had differential effects on the transcription levels of the other three genes in the operon. Conclusions The MamX protein plays an important role in controlling magnetosome size, maturation, and crystal form. The four MamXY proteins appear to have redundant functions involved in magnetosome formation. Our findings provide new insights into the coordinated function of MAI genes and operons in magnetosome formation. PMID:24020498

  3. Antithrombin activities in childhood malnutrition.

    PubMed Central

    Jiménez, R A; Jiménez, E; Ingram, G I; Mora, L A; Atmetlla, F; Carrillo, J M; Vargas, W

    1979-01-01

    Antithrombin activities in 30 severely malnourished children and 40 normal children were estimated in clotting tests by thrombin neutralisation as anti-Xa and by a heparin antithrombin assay; and by immunodiffusion as alpha 2-globulin and alpha 1-antitrypsin. The patients' mean alpha 2-globulin was severely depressed, and there were less marked depletions in mean values for thrombin neutralisation, anti-Xa, and in the heparin antithrombin assay (which showed the flat curve thought to reflect a thrombotic tendency). The alpha 1-antitrypsin values were normal. The findings support the concept of antithrombin as the summation of alpha 2-globulin and alpha 1-antitrypsin (with alpha 2-macroglobulin); and the low values may be related to the high incidence of thrombosis reported in childhood malnutrition, although it was not seen in these patients. PMID:118190

  4. MAM3 catalyzes the formation of all aliphatic glucosinolate chain lengths in Arabidopsis.

    PubMed

    Textor, Susanne; de Kraker, Jan-Willem; Hause, Bettina; Gershenzon, Jonathan; Tokuhisa, James G

    2007-05-01

    Chain elongated, methionine (Met)-derived glucosinolates are a major class of secondary metabolites in Arabidopsis (Arabidopsis thaliana). The key enzymatic step in determining the length of the chain is the condensation of acetyl-coenzyme A with a series of omega-methylthio-2-oxoalkanoic acids, catalyzed by methylthioalkylmalate (MAM) synthases. The existence of two MAM synthases has been previously reported in the Arabidopsis ecotype Columbia: MAM1 and MAM3 (formerly known as MAM-L). Here, we describe the biochemical properties of the MAM3 enzyme, which is able to catalyze all six condensation reactions of Met chain elongation that occur in Arabidopsis. Underlining its broad substrate specificity, MAM3 also accepts a range of non-Met-derived 2-oxoacids, e.g. converting pyruvate to citramalate and 2-oxoisovalerate to isopropylmalate, a step in leucine biosynthesis. To investigate its role in vivo, we identified plant lines with mutations in MAM3 that resulted in a complete lack or greatly reduced levels of long-chain glucosinolates. This phenotype could be complemented by reintroduction of a MAM3 expression construct. Analysis of MAM3 mutants demonstrated that MAM3 catalyzes the formation of all glucosinolate chain lengths in vivo as well as in vitro, making this enzyme the major generator of glucosinolate chain length diversity in the plant. The localization of MAM3 in the chloroplast suggests that this organelle is the site of Met chain elongation. PMID:17369439

  5. A monoclonal antibody specific for 6-monoacetylmorphine reduces acute heroin effects in mice.

    PubMed

    Bogen, Inger Lise; Boix, Fernando; Nerem, Elisabeth; Mørland, Jørg; Andersen, Jannike Mørch

    2014-06-01

    Immunotherapy against drugs of abuse is being studied as an alternative treatment option in addiction medicine and is based on antibodies sequestering the drug in the bloodstream and blocking its entry into the brain. Producing an efficient vaccine against heroin has been considered particularly challenging because of the rapid metabolism of heroin to multiple psychoactive molecules. We have previously reported that heroin's first metabolite, 6-monoacetylmorphine (6-MAM), is the predominant mediator for heroin's acute behavioral effects and that heroin is metabolized to 6-MAM primarily prior to brain entry. On this basis, we hypothesized that antibody sequestration of 6-MAM is sufficient to impair heroin-induced effects and therefore examined the effects of a monoclonal antibody (mAb) specific for 6-MAM. In vitro experiments in human and rat blood revealed that the antibody was able to bind 6-MAM and block the metabolism to morphine almost completely, whereas the conversion of heroin to 6-MAM remained unaffected. Mice pretreated with the mAb toward 6-MAM displayed a reduction in heroin-induced locomotor activity that corresponded closely to the reduction in brain 6-MAM levels. Intraperitoneal and intravenous administration of the anti-6-MAM mAb gave equivalent protection against heroin effects, and the mAb was estimated to have a functional half-life of 8 to 9 days in mice. Our study implies that an antibody against 6-MAM is effective in counteracting heroin effects. PMID:24700886

  6. Undernutrition, risk of malnutrition and obesity in gastroenterological patients: A multicenter study

    PubMed Central

    Rizzi, Massimiliano; Mazzuoli, Silvia; Regano, Nunzia; Inguaggiato, Rosa; Bianco, Margherita; Leandro, Gioacchino; Bugianesi, Elisabetta; Noè, Donatella; Orzes, Nicoletta; Pallini, Paolo; Petroni, Maria Letizia; Testino, Gianni; Guglielmi, Francesco William

    2016-01-01

    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 three-six 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. PMID:27559436

  7. Safety and Efficacy of Low-osmolarity ORS vs. Modified Rehydration Solution for Malnourished Children for Treatment of Children with Severe Acute Malnutrition and Diarrhea: A Randomized Controlled Trial.

    PubMed

    Kumar, Ruchika; Kumar, Praveen; Aneja, S; Kumar, Virendra; Rehan, Harmeet S

    2015-12-01

    World Health Organization-recommended rehydration solution for malnourished children (ReSoMal) for rehydrating severe acute malnourished children is not available in India. In present study, 110 consecutive children aged 6-59 months with severely acute malnourishment and acute diarrhea were randomized to low-osmolarity oral rehydration solution (ORS) (osmolarity: 245, sodium: 75) with added potassium (20 mmol/l) or modified ReSoMal (osmolarity: 300, sodium: 45). In all, 15.4% of modified ReSoMal group developed hyponatremia as compared with 1.9% in low-osmolarity ORS, but none developed severe hyponatremia or hypernatremia. Both groups had equal number of successful rehydration (52 each). Both types of ORS were effective in correcting hypokalemia and dehydration, but rehydration was achieved in shorter duration with modified ReSoMal. PMID:26314308

  8. New Mexico Campaigns Against Hunger and Malnutrition

    ERIC Educational Resources Information Center

    Lubin, Shami

    1972-01-01

    Describes the nutritional needs of individuals in New Mexico, and the efforts of the Nutrition Improvement Program (NIP) of the University of New Mexico School of Medicine at Albuquerque to remove hunger and malnutrition. (DM)

  9. Malnutrition and vaccination in developing countries

    PubMed Central

    Prendergast, Andrew J.

    2015-01-01

    Malnutrition contributes to an estimated 45% of deaths among children under 5 years of age in developing countries, predominantly due to infections. Malnourished children therefore stand to benefit hugely from vaccination, but malnutrition has been described as the most common immunodeficiency globally, suggesting that they may not be able to respond effectively to vaccines. The immunology of malnutrition remains poorly characterized, but is associated with impairments in mucosal barrier integrity, and innate and adaptive immune dysfunction. Despite this, the majority of malnourished children can mount a protective immune response following vaccination, although the timing, quality and duration of responses may be impaired. This paper reviews the evidence for vaccine immunogenicity in malnourished children, discusses the importance of vaccination in prevention of malnutrition and highlights evidence gaps in our current knowledge. PMID:25964453

  10. Hospital Malnutrition Related to Fasting and Underfeeding: Is It an Ethical Issue?

    PubMed

    Arenas Moya, Diego; Plascencia Gaitán, Alejandra; Ornelas Camacho, Denisse; Arenas Márquez, Humberto

    2016-06-01

    Hospital malnutrition is a relevant clinical issue present in about 50% of patients that is associated with increased morbidity, mortality, and cost of care. Because of the relation of malnutrition with chronic and acute inflammatory processes secondary to disease, nutrition therapy is considered an important medical treatment. However, there is little discussion about the impact of another critical issue related to hospital malnutrition, that is, lack of appropriate food or nutrition therapy given to the patients. Unnecessary fasting practices and the use of inappropriate nutrition prescriptions result in underfeeding that can be a related or direct cause of hospital malnutrition, independent of disease or inflammatory state. Suboptimal prescription of oral, enteral, and parenteral nutrition should be analyzed and discussed from an ethical perspective since this practice has the potential to harm patients. In addition, absence or inadequate provision of nutrition may present barriers for improved patient outcomes and could be prevented by simply recognizing lack of knowledge, skills, or experience in nutrition and entrusting nutrition prescription to interdisciplinary teams with clinicians well prepared in nutrition sciences. This article reviews potential barriers to the prevention or treatment of hospital malnutrition and proposes specific actions that can help clinicians to overcome and implement optimal nutrition not just as medical therapy but also as a basic comfort care that may help patients nutritionally, clinically, physically, and emotionally. PMID:27208012

  11. Childhood malnutrition: Toward an understanding of infections, inflammation, and antimicrobials

    PubMed Central

    Jones, Kelsey D.; Thitiri, Johnstone; Ngari, Moses; Berkley, James A.

    2014-01-01

    Background Undernutrition in childhood is estimated to cause 3.1 million child deaths annually through a potentiating effect on common infectious diseases, such as pneumonia and diarrhea. In turn, overt and subclinical infections, and inflammation, especially in the gut, alter nutrient intake, absorption, secretion, diversion, catabolism, and expenditure. Objective A narrative overview of the current understanding of infections, inflammation, and antimicrobials in relation to childhood malnutrition. Methods Searches for pivotal papers were conducted using PUBMED 1966-January 2013; hand searches of the references of retrieved literature; discussions with experts; and personal experience from the field. Results Although the epidemiological evidence for increased susceptibility to life-threatening infections associated with malnutrition is strong, we are only just beginning to understand some of the mechanisms involved. Nutritional status and growth are strongly influenced by environmental enteric dysfunction (EED), which is common among children in developing countries, and by alterations in the gut microbiome. As yet, there are no proven interventions against EED. Antibiotics have long been used as growth promoters in animals. Trials of antibiotics have shown striking efficacy on mortality and on growth in children with uncomplicated severe acute malnutrition (SAM) or HIV infection. Antibiotics act directly by preventing infections and may act indirectly by reducing subclinical infections and inflammation. We describe an ongoing multicenter, randomized, placebo-controlled trial of daily cotrimoxazole prophylaxis to prevent death in children recovering from complicated SAM. Secondary outcomes include growth, frequency and etiology of infections, immune activation and function, the gut microbiome, and antimicrobial resistance. The trial is expected to be reported in mid-2014. Conclusions As well as improving nutritional intake, new case management strategies need to

  12. Malnutrition as a Precursor of Pressure Ulcers

    PubMed Central

    Litchford, Mary D.; Dorner, Becky; Posthauer, Mary Ellen

    2014-01-01

    Significance: Numerous studies have reported associations between declining nutrition status and risk for pressure ulcers. Oral eating problems, weight loss, low body weight, undernutrition, and malnutrition are associated with an increased risk for pressure ulcers. Moreover, inadequate nutrient intake and low body weight are associated with slow and nonhealing wounds. However, the biologic significance of deterioration in nutrition status and consistent methodologies to quantify malnutrition and diminished micronutrient stores as predictors of skin breakdown remains controversial. Recent Advances: The Academy of Nutrition and Dietetics (Academy) and the American Society for Parenteral and Enteral Nutrition (ASPEN) Consensus Statement: Characteristics Recommended for the Identification and Documentation of Adult Malnutrition provide a standardized and measureable set of criterion for all health professionals to use to identify malnutrition. The Agency for Healthcare Research and Quality identified malnutrition as one of the common geriatric syndromes associated with increased risk for institutionalization and mortality that may be impacted by primary and secondary preventions. Critical Issues: The purpose of this article is to examine the Academy/ASPEN consensus statement on characteristics of adult malnutrition in the context of the National Pressure Ulcer Advisory Panel (NPUAP)/European Pressure Ulcer Advisory Panel (EPUAP) Guidelines on the Prevention and Treatment of Pressure Ulcers. Future Directions: Moreover, clinicians, and in particular, registered dietitians have the opportunity to integrate the Characteristics of Malnutrition with the NPUAP/EPUAP 2009 Prevention and Treatment Clinical Practice Guidelines, into clinical assessment and documentation using the Nutrition Care Process. Consensus guidelines will provide consistent research criteria yielding more useful data than presently available. PMID:24761345

  13. Malnutrition as a Precursor of Pressure Ulcers.

    PubMed

    Litchford, Mary D; Dorner, Becky; Posthauer, Mary Ellen

    2014-01-01

    Significance: Numerous studies have reported associations between declining nutrition status and risk for pressure ulcers. Oral eating problems, weight loss, low body weight, undernutrition, and malnutrition are associated with an increased risk for pressure ulcers. Moreover, inadequate nutrient intake and low body weight are associated with slow and nonhealing wounds. However, the biologic significance of deterioration in nutrition status and consistent methodologies to quantify malnutrition and diminished micronutrient stores as predictors of skin breakdown remains controversial. Recent Advances: The Academy of Nutrition and Dietetics (Academy) and the American Society for Parenteral and Enteral Nutrition (ASPEN) Consensus Statement: Characteristics Recommended for the Identification and Documentation of Adult Malnutrition provide a standardized and measureable set of criterion for all health professionals to use to identify malnutrition. The Agency for Healthcare Research and Quality identified malnutrition as one of the common geriatric syndromes associated with increased risk for institutionalization and mortality that may be impacted by primary and secondary preventions. Critical Issues: The purpose of this article is to examine the Academy/ASPEN consensus statement on characteristics of adult malnutrition in the context of the National Pressure Ulcer Advisory Panel (NPUAP)/European Pressure Ulcer Advisory Panel (EPUAP) Guidelines on the Prevention and Treatment of Pressure Ulcers. Future Directions: Moreover, clinicians, and in particular, registered dietitians have the opportunity to integrate the Characteristics of Malnutrition with the NPUAP/EPUAP 2009 Prevention and Treatment Clinical Practice Guidelines, into clinical assessment and documentation using the Nutrition Care Process. Consensus guidelines will provide consistent research criteria yielding more useful data than presently available. PMID:24761345

  14. Translating the MAM Model of Psychosis to Humans

    PubMed Central

    Modinos, Gemma; Allen, Paul; Grace, Anthony A.; McGuire, Philip

    2015-01-01

    Elevated dopamine function and alterations in the medial temporal lobe structure and function (MTL) are two of the most robust findings in schizophrenia, but how interactions between these abnormalities underlie the onset of psychosis is unclear. Although several preclinical models of psychosis have been proposed, the methylazoxymethanol acetate (MAM) rodent model provides a mechanistic account linking these two clinical observations. The model proposes that psychosis develops as a result of a perturbation of MTL function, leading to elevated striatal dopamine dysfunction. We review a number of recent neuroimaging studies that examine components of the putative model in people with an ultra high risk (UHR) of psychosis. Whilst data from these studies are broadly consistent with the MAM model, that the potential for comparing various kinds of neurobiological data across animal and human studies imposes some limitations on what can be inferred from these data. Going forward, longitudinal studies are needed to explicitly test the model’s predictions in UHR populations. PMID:25554679

  15. Addressing Disease-Related Malnutrition in Healthcare

    PubMed Central

    Correia, Maria Isabel; Hegazi, Refaat A.; Diaz-Pizarro Graf, José Ignacio; Gomez-Morales, Gabriel; Fuentes Gutiérrez, Catalina; Goldin, Maria Fernanda; Navas, Angela; Pinzón Espitia, Olga Lucia; Tavares, Gilmária Millere

    2015-01-01

    Alarmingly high rates of disease-related malnutrition have persisted in hospitals of both emerging and industrialized nations over the past 2 decades, despite marked advances in medical care over this same interval. In Latin American hospitals, the numbers are particularly striking; disease-related malnutrition has been reported in nearly 50% of adult patients in Argentina, Brazil, Chile, Costa Rica, Cuba, Dominican Republic, Ecuador, Mexico, Panama, Paraguay, Peru, Puerto Rico, Venezuela, and Uruguay. The tolls of disease-related malnutrition are high in both human and financial terms—increased infectious complications, higher incidence of pressure ulcers, longer hospital stays, more frequent readmissions, greater costs of care, and increased risk of death. In an effort to draw attention to malnutrition in Latin American healthcare, a feedM.E. Latin American Study Group was formed to extend the reach and support the educational efforts of the feedM.E. Global Study Group. In this article, the feedM.E. Latin American Study Group shows that malnutrition incurs excessive costs to the healthcare systems, and the study group also presents evidence of how appropriate nutrition care can improve patients’ clinical outcomes and lower healthcare costs. To achieve the benefits of nutrition for health throughout Latin America, the article presents feedM.E.’s simple and effective Nutrition Care Pathway in English and Spanish as a way to facilitate its use. PMID:25883116

  16. Malnutrition coding 101: financial impact and more.

    PubMed

    Giannopoulos, Georgia A; Merriman, Louise R; Rumsey, Alissa; Zwiebel, Douglas S

    2013-12-01

    Recent articles have addressed the characteristics associated with adult malnutrition as published by the Academy of Nutrition and Dietetics (the Academy) and the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). This article describes a successful interdisciplinary program developed by the Department of Food and Nutrition at New York-Presbyterian Hospital to maintain and monitor clinical documentation, ensure accurate International Classification of Diseases 9th Edition (ICD-9) coding, and identify subsequent incremental revenue resulting from the early identification, documentation, and treatment of malnutrition in an adult inpatient population. The first step in the process requires registered dietitians to identify patients with malnutrition; then clear and specifically worded diagnostic statements that include the type and severity of malnutrition are documented in the medical record by the physician, nurse practitioner, or physician's assistant. This protocol allows the Heath Information Management/Coding department to accurately assign ICD-9 codes associated with protein-energy malnutrition. Once clinical coding is complete, a final diagnosis related group (DRG) is generated to ensure appropriate hospital reimbursement. Successful interdisciplinary programs such as this can drive optimal care and ensure appropriate reimbursement. PMID:24177283

  17. Crusade against Malnutrition: Nutrition Education Program.

    PubMed

    Elizabeth, K E

    2016-03-01

    A holistic approach in assessment and plan for intervention in childhood malnutrition is the need of the hour. This is in the context of nutrition education program (NEP), undertaken under the National IAP action plan, 2015. In the crusade against malnutrition, an ABCDEFQ assessment scale is recommended, with aspects covering anthropometric, biochemical, clinical, dietary, ecological/epidemiological, functional parameters and quality of life. In the dietary assessment, a scoring system based on the ten interventions related to infant and young child feeding (IYCF) practices recommended by UNICEF and the food frequency table score are incorporated. In the evaluation of quality of life and plan for intervention, a tool called IMPACT (IAP Malnutrition Proactive Assessment: A Comprehensive Tool) is proposed. PMID:27029680

  18. [Malnutrition as an international problem (author's transl)].

    PubMed

    Cremer, H D

    1976-01-01

    The importance of malnutrition as an international problem is illustrated by some examples. Attention is mainly focussed on the bipolarity of this problem: malnutrition, both qualitative and quantitative, as the main nutritional problem of most of the developing countries of the Third World, overfeeding nowadays so associated with qualitative malnutrition - as the most important alimentary problem in the Federal Republic of Germany, but applying equally to other highly industrialized and civilized countries in Western Europe, the United States and Australia. Perhaps it would be more to the point to speak of prosperous countries or populations because these diseases found in technically highly developed countries increasingly occur also in developing countries among those social classes who believe they are able to afford a "better" nutrition and fall from one extreme of malnutrition into the other. Correct nutrition considered to be a privilege or a direct consequence of social prosperity is certainly not justified. The improvement in the standard of living as such by no means guaranties well-balanced nutrition. To quote an example: in developing countries when people live by trading with certain limited products, alimentary habits tend to change when the prices of the products go up. However, this is by no means invariably a change for the better, but quite often for the worse. It has repeatedly been found that in tropical countries where copra is the staple trading product, nutrition did not improve as the copra price rose. On the contrary, nutrition deteriorated because the people increasingly turned from the self-cultivated "natural products" to imported, refined food stuffs and tinned foods purely for reasons of increased prestige associated with such a diet. The consequences of malnutrition in the developing countries are dealt with in greater detail. In dealing with the consequences of malnutrition in highly industrialized countries a restriction to a few

  19. Determinants of Growth Hormone Resistance in Malnutrition

    PubMed Central

    Fazeli, Pouneh K.; Klibanski, Anne

    2014-01-01

    States of under-nutrition are characterized by growth hormone resistance. Decreased total energy intake, as well as isolated protein-calorie malnutrition and isolated nutrient deficiencies result in elevated growth hormone levels and low levels of IGF-I. We review various states of malnutrition and a disease state characterized by chronic under-nutrition -- anorexia nervosa -- and discuss possible mechanisms contributing to the state of growth hormone resistance, including FGF-21 and SIRT1. We conclude by examining the hypothesis that growth hormone resistance is an adaptive response to states of under-nutrition, in order to maintain euglycemia and preserve energy. PMID:24363451

  20. Malnutrition, Learning and Intellectual Development: Research and Remediation.

    ERIC Educational Resources Information Center

    Ricciuti, Henry N.

    After a discussion of the problem of malnutrition and its effect on intellectual development, this paper concentrates on the study of protein-calorie malnutrition in infants and children as it occurs in postnatal and subsequent development. An overview and summary of the principal investigations on the relationship of malnutrition to intellectual…

  1. Undernutrition malnutrition in infants in developing countries

    Technology Transfer Automated Retrieval System (TEKTRAN)

    We commend Dr. Humphrey on an insightful and well-written editorial on infant underweight malnutrition and thank her for her interest in our study on this topic. In our trial, provision of fortified spread, a novel lipid-based nutrient supplement, to Malawian infants was associated with a markedly ...

  2. Protein metabolism in severe childhood malnutrition

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The major clinical syndromes of severe childhood malnutrition (SCM) are marasmus (non-oedematous SCM), kwashiorkor and marasmic-kwashiorkor (oedematous SCM). Whereas treatment of marasmus is straightforward and the associated mortality is low, kwashiorkor and marasmic-kwashiorkor are difficult to tr...

  3. Spirulina: The Alga That Can End Malnutrition.

    ERIC Educational Resources Information Center

    Fox, Ripley D.

    1985-01-01

    One approach to eliminating malnutrition worldwide is to grow spirulina in recycled village wastes. Spirulina is a blue-green alga and a natural concentrated food. Spirulina can give poor villages a nutritional food supplement they can grow themselves and can reduce infectious disease at the same time. (Author/RM)

  4. Flight solar calibrations using the mirror attenuator mosaic (MAM) - Low scattering mirror

    NASA Technical Reports Server (NTRS)

    Lee, Robert B., III

    1991-01-01

    The solar calibration instrumentation and approaches to the scanning radiometers in the ERBE experiment are described in detail. Emphasis is given to evaluating the stability of the mirror attenuator mosaic (MAM) solar diffusing plate. Flight and ground MAM calibration measurements are presented and compared.

  5. Lineage-specific evolution of Methylthioalkylmalate synthases (MAMs) involved in glucosinolates biosynthesis.

    PubMed

    Zhang, Jifang; Wang, Xiaobo; Cheng, Feng; Wu, Jian; Liang, Jianli; Yang, Wencai; Wang, Xiaowu

    2015-01-01

    Methylthioalkylmalate synthases (MAMs) encoded by MAM genes are central to the diversification of the glucosinolates, which are important secondary metabolites in Brassicaceae species. However, the evolutionary pathway of MAM genes is poorly understood. We analyzed the phylogenetic and synteny relationships of MAM genes from 13 sequenced Brassicaceae species. Based on these analyses, we propose that the syntenic loci of MAM genes, which underwent frequent tandem duplications, divided into two independent lineage-specific evolution routes and were driven by positive selection after the divergence from Aethionema arabicum. In the lineage I species Capsella rubella, Camelina sativa, Arabidopsis lyrata, and A. thaliana, the MAM loci evolved three tandem genes encoding enzymes responsible for the biosynthesis of aliphatic glucosinolates with different carbon chain-lengths. In lineage II species, the MAM loci encode enzymes responsible for the biosynthesis of short-chain aliphatic glucosinolates. Our proposed model of the evolutionary pathway of MAM genes will be useful for understanding the specific function of these genes in Brassicaceae species. PMID:25691886

  6. Lineage-specific evolution of Methylthioalkylmalate synthases (MAMs) involved in glucosinolates biosynthesis

    PubMed Central

    Zhang, Jifang; Wang, Xiaobo; Cheng, Feng; Wu, Jian; Liang, Jianli; Yang, Wencai; Wang, Xiaowu

    2015-01-01

    Methylthioalkylmalate synthases (MAMs) encoded by MAM genes are central to the diversification of the glucosinolates, which are important secondary metabolites in Brassicaceae species. However, the evolutionary pathway of MAM genes is poorly understood. We analyzed the phylogenetic and synteny relationships of MAM genes from 13 sequenced Brassicaceae species. Based on these analyses, we propose that the syntenic loci of MAM genes, which underwent frequent tandem duplications, divided into two independent lineage-specific evolution routes and were driven by positive selection after the divergence from Aethionema arabicum. In the lineage I species Capsella rubella, Camelina sativa, Arabidopsis lyrata, and A. thaliana, the MAM loci evolved three tandem genes encoding enzymes responsible for the biosynthesis of aliphatic glucosinolates with different carbon chain-lengths. In lineage II species, the MAM loci encode enzymes responsible for the biosynthesis of short-chain aliphatic glucosinolates. Our proposed model of the evolutionary pathway of MAM genes will be useful for understanding the specific function of these genes in Brassicaceae species. PMID:25691886

  7. Natural Variation in MAM Within and Between Populations of Arabidopsis lyrata Determines Glucosinolate Phenotype

    PubMed Central

    Heidel, Andrew J.; Clauss, Maria J.; Kroymann, Juergen; Savolainen, Outi; Mitchell-Olds, Thomas

    2006-01-01

    The genetic variation that underlies the glucosinolate phenotype of Arabidopsis lyrata ssp. petraea was investigated between and within populations. A candidate glucosinolate biosynthetic locus (MAM, containing methylthioalkylmalate synthase genes) was mapped in A. lyrata to a location on linkage group 6 corresponding to the homologous location for MAM in A. thaliana. In A. thaliana MAM is responsible for side chain elongation in aliphatic glucosinolates, and the MAM phenotype can be characterized by the ratios of long- to short-chain glucosinolates. A quantitative trait loci (QTL) analysis of glucosinolate ratios in an A. lyrata interpopulation cross found one QTL at MAM. Additional QTL were identified for total indolic glucosinolates and for the ratio of aliphatic to indolic glucosinolates. MAM was then used as the candidate gene for a within-population cosegregation analysis in a natural A. lyrata population from Germany. Extensive variation in microsatellite markers at MAM was found and this variation cosegregated with the same glucosinolate ratios as in the QTL study. The combined results indicate that both between- and within-population genetic variation in the MAM region determines phenotypic variation in glucosinolate side chains in A. lyrata. PMID:16702431

  8. Calibration, navigation, and registration of MAMS data for FIFE

    NASA Technical Reports Server (NTRS)

    Jedlovec, G. J.; Atkinson, R. J.

    1993-01-01

    The International Satellite Land Surface Climatology Project (ISLSCP) was conducted to study the interaction of the atmosphere with the land surface and the research problems associated with the interpretation of satellite data over the Earth's land surface. The experimental objectives of the First ISLSCP Field Experiment (FIFE) were the simultaneous acquisition of satellite, atmospheric, and surface data and to use these data to understand the processes controlling energy/mass exchange at the surface. The experiment site is a 15 x 15 km area southeast of Manhattan, Kansas, intersected by Interstate 70 and Kansas highway 177. The Konza Prairie portion is 5 x 5 km and is a controlled experiment site consisting primarily of native tall grass prairie vegetation. The remainder of the site is grazing and farm land with trees along creek beds that are scattered over the area. Airborne multispectral imagery from the Multispectral Atmospheric Mapping Sensor (MAMS) was collected over this region on two days during Intensive Field Campaign-1 (1FC-1) to study the time and space variability of remotely-sensed geophysical parameters. These datasets consist of multiple overflights covering about a 60-min period during late morning on June 4, 1987 and shortly after dark on the following day. Image data from each overpass were calibrated and Earth located with respect to each other using aircraft inertial navigation system parameters and ground control points. These were the first MAMS flights made with 10-bit thermal data.

  9. MamK, a bacterial actin, forms dynamic filaments in vivo that are regulated by the acidic proteins MamJ and LimJ

    PubMed Central

    Draper, Olga; Byrne, Meghan E.; Li, Zhuo; Keyhani, Sepehr; Cueto Barrozo, Joyce; Jensen, Grant; Komeili, Arash

    2011-01-01

    SUMMARY Bacterial actins, in contrast to their eukaryotic counterparts, are highly divergent proteins whose wide-ranging functions are thought to correlate with their evolutionary diversity. One clade, represented by the MamK protein of magnetotactic bacteria, is required for the subcellular organization of magnetosomes, membrane-bound organelles that aid in navigation along the earth’s magnetic field. Using a fluorescence recovery after photobleaching assay in Magnetospirillum magneticum AMB-1, we find that, like traditional actins, MamK forms dynamic filaments that require an intact NTPase motif for their turnover in vivo. We also uncover two proteins, MamJ and LimJ, which perform a redundant function to promote the dynamic behavior of MamK filaments in wildtype cells. The absence of both MamJ and LimJ leads to static filaments, a disrupted magnetosome chain, and an anomalous build-up of cytoskeletal filaments between magnetosomes. Our results suggest that MamK filaments, like eukaryotic actins, are intrinsically stable and rely on regulators for their dynamic behavior, a feature that stands in contrast to some classes of bacterial actins characterized to date. PMID:21883528

  10. Elder insecurities: poverty, hunger, and malnutrition.

    PubMed

    Wellman, N S; Weddle, D O; Kranz, S; Brain, C T

    1997-10-01

    Between 8% and 16% (2.5 to 4.9 million) of the elder population have experienced food insecurity within a 6-month period. Federal programs to combat food insecurity reach only one-third of needy elders. While hunger and poverty are linked directly to malnutrition, the multifaceted nature of elderly malnutrition cuts across all economic, racial, and ethnic groups. Malnourished patients experience 2 to 20 times more complications, have up to 100% longer hospital stays, and compile hospital costs $2,000 to $10,000 higher per stay. Dietitians can advocate routine nutrition screening to target elders at highest risk and lobby for expansion of appropriate nutrition services in home, community, and institutional settings. PMID:9336570

  11. Malnutrition and disability: unexplored opportunities for collaboration

    PubMed Central

    Groce, N; Challenger, E; Berman-Bieler, R; Farkas, A; Yilmaz, N; Schultink, W; Clark, D; Kaplan, C; Kerac, M

    2014-01-01

    There is increasing international interest in the links between malnutrition and disability: both are major global public health problems, both are key human rights concerns, and both are currently prominent within the global health agenda. In this review, interactions between the two fields are explored and it is argued that strengthening links would lead to important mutual benefits and synergies. At numerous points throughout the life-cycle, malnutrition can cause or contribute to an individual’s physical, sensory, intellectual or mental health disability. By working more closely together, these problems can be transformed into opportunities: nutrition services and programmes for children and adults can act as entry points to address and, in some cases, avoid or mitigate disability; disability programmes can improve nutrition for the children and adults they serve. For this to happen, however, political commitment and resources are needed, as are better data. PMID:25309998

  12. Malnutrition and a rash: think zinc.

    PubMed

    Roberts, C M L; Martin-Clavijo, A; Winston, A P; Dharmagunawardena, B; Gach, J E

    2007-11-01

    Endemic zinc deficiency is recognised to be a common and serious problem in developing countries. However, it may be seen in routine practice in the UK, and can be easily overlooked. Malnutrition from any cause in conjunction with an undiagnosed cutaneous problem should alert the clinician to the diagnosis. Investigations may be unreliable, and if in doubt, a therapeutic trial of zinc supplementation is indicated. We present three cases of malnourished patients, in whom zinc deficiency was diagnosed after the development of cutaneous features. The malnutrition resulted from alcoholism in two cases and anorexia nervosa in the third. The heterogeneity of underlying causes of zinc deficiency is discussed, along with its effects, treatment and zinc homeostasis. PMID:17953634

  13. Major Barriers Responsible for Malnutrition in Hemodialysis Patients: Challenges to Optimal Nutrition

    PubMed Central

    Ekramzadeh, Maryam; Mazloom, Zohreh; Jafari, Peyman; Ayatollahi, Maryam; Sagheb, Mohammad Mahdi

    2014-01-01

    Background: Nutritional barriers may contribute to malnutrition in hemodialysis (HD) patients. Higher rates of morbidity and mortality rates have been reported in malnourished HD patients. These patients are faced with different challenges affecting their nutritional status. Objectives: The aim of this cross-sectional study was to identify most important barriers responsible for malnutrition in HD patients. Patients and Methods: We randomly selected 255 of 800 stable HD patients from three HD centers with an age range of 18-85 years, who had been on hemodialysis for at least three months without any acute illness. Each patient was interviewed to evaluate malnutrition [subjective global assessment (SGA), malnutrition inflammation score (MIS)], and potential medical, behavioral and socioeconomic barriers. Body composition of patients was checked through bioelectrical impedance analysis (BIA). Routine clinical markers of malnutrition such as serum albumin and total protein were measured using standard automated techniques. Binary logistic regression model was used to find the association between nutritional markers and potential barriers. Results: Patients with higher SGA had lower knowledge about general nutrition [odds ratio (OR), 1.3], potassium (OR, 1.89), difficulty chewing (OR, 1.16), and shopping (OR, 1.16). Those with greater MIS scores had poor appetite (OR, 1.3), depression (OR, 1.21), and difficulty with cooking (OR, 1.15). Lower BCM (body cell mass) was associated with poor appetite (OR, 0.92) and needed help for cooking (OR, 0.88). Patients with higher BFMI (body fat mass index) had insufficient general nutrition (OR, 1.15), and protein (OR, 1.27) knowledge, and needed help for shopping (OR, 1.14). Moreover, patients with higher SGA scores were those with older age and longer duration of HD. Conclusions: Three medical barriers (poor appetite, depression and difficulty chewing), one behavioral barrier (poor total nutrition, protein, and potassium knowledge

  14. Acquired protein energy malnutrition in glutaric acidemia.

    PubMed

    Ma, Liqiao; Savory, Stephanie; Agim, Nnenna G

    2013-01-01

    We report a case of acquired protein energy malnutrition with associated zinc deficiency in an 18-month-old boy with type 1 glutaric acidemia. Physical examination findings included generalized nonpitting edema, widespread desquamative plaques, and sparse hair with a reddish tinge. Laboratory abnormalities included low levels of zinc, albumin, alkaline phosphatase, and iron. A review of skin manifestations of nutritional deficiencies, specifically kwashiorkor, is presented, as well as the relatively new entity called acrodermatitis dysmetabolica. PMID:23330977

  15. [The war against malnutrition in rural areas].

    PubMed

    Sall, G

    1990-04-01

    This article analyzes the interaction between nutritional factors and growth rates in Senegal from data collected at the pediatric unit at the CHU Hospital in Dakar. In Senegal, as in most of Sub-Saharan Africa (SSA) children grow rapidly between 6-36 months because of good nutrition. The problems cited during the survey that have led to malnutrition among infants and children are: 1) the lack of education of mothers; 2) demographic factors (many pregnancies and polygamy); 3) maldistribution of f ood especially when children eat from the same bowl as adults; 4) the lack of diversification in food given to infants after 5 months; 5) special foods considered taboos (eggs, dried fish, some vegetables) limits children's consumption of a balanced diet; 6) abusive malnutritional publicity campaigns that encourage mothers to purchase imported milk and food products; 7) high poverty level of most malnourished children due to the parents unemployment, and 8) the lack of immunization and medical surveillance. These factors explain what happens to most SSA children after beginning the 16 month when the lack of adequate and diversified nutrition causes retardation in their growth rates. The prevalence of marasmus is responsible for 50% of all deaths in Dakar due to malnutrition. The intervention of special foods such as "Ladylac" "Ferelin" and the "rouye-complet" form Dakar's Institute of Food Technology have had positive results in producing nutritional rehabilitation. However, the price remains a problem because the majority of the people are so poor. Recommendations to win the war against child malnutrition includes: 1) nutritional and health programs aimed at the literacy levels of Senegalese families; 2) controls on polygamy; 3) a policy on family planning; 4) increasing family revenues and the availability of local infant products; 5) improvement in the health system and inclusion of nutritional education in the training of health workers. PMID:12283236

  16. INCAP studies of malnutrition and cognitive behavior.

    PubMed

    Engle, Patrice L; Fernández, Patricia D

    2010-03-01

    The Institute of Nutrition of Central America and Panama (INCAP) has made major contributions to the study of the effects of malnutrition on learning. This report summarizes work on the relationship of nutrition to children's learning and development from the 1960's through 1998. The Oriente Longitudinal Study examined the effects of two types of supplementation for mothers and young children on their growth and development (an energy-only drink compared with a protein-energy drink) using a quasi-experimental design. Both drinks were supplemented with micronutrients, and were offered daily. As a result of the research on malnutrition and mental development, researchers could conclude by 1993 that supplementary feeding of infants and young children resulted in significant increases cognitive development and school performance through adolescence. The research also suggested that the pathways that link malnutrition with later development are not only through the neurological system but also operate through changes in child behavior which affect the kinds of care children receive. Other research on learning and development showed that families understood the concept of intelligence, demonstrated the link between micronutrients and cognitive development, and documented the amount of wastage or repetition and drop-out that occurs in Guatemalan schools. PMID:20461906

  17. Malnutrition and Cachexia in Heart Failure.

    PubMed

    Rahman, Adam; Jafry, Syed; Jeejeebhoy, Khursheed; Nagpal, A Dave; Pisani, Barbara; Agarwala, Ravi

    2016-05-01

    Heart failure is a growing public health concern. Advanced heart failure is frequently associated with severe muscle wasting, termed cardiac cachexia This process is driven by systemic inflammation and tumor necrosis factor in a manner common to other forms of disease-related wasting seen with cancer or human immunodeficiency virus. A variable degree of malnutrition is often superimposed from poor nutrient intake. Cardiac cachexia significantly decreases quality of life and survival in patients with heart failure. This review outlines the evaluation of nutrition status in heart failure, explores the pathophysiology of cardiac cachexia, and discusses therapeutic interventions targeting wasting in these patients. PMID:25634161

  18. HOME-BASED THERAPY FOR OEDEMATOUS MALNUTRITION WITH READY-TO-USE THERAPEUTIC FOOD

    Technology Transfer Automated Retrieval System (TEKTRAN)

    BACKGROUND: Standard recommendations are that children with oedematous malnutrition receive inpatient therapy with a graduated feeding regimen. Aim: To investigate exclusive home-based therapy for children with oedematous malnutrition. METHODS: Children with oedematous malnutrition, good appetite, a...

  19. Are we Underestimating the Real Burden of Malnutrition? An Experience From Community-Based Study

    PubMed Central

    Agarwal, Disha; Misra, Sunil Kumar; Chaudhary, Shailendra Singh; Prakash, Gyan

    2015-01-01

    Background: Since the inception of childhood nutritional programs in India, underweight has been taken to judge the nutritional status of children; but is it a true indicator of overall prevalence of malnutrition in a community? Objective: To estimate the overall prevalence of malnutrition by using Composite Index of Anthropometric Failure (CIAF) and to assess its usefulness over various conventional anthropometric indicators among under 5 children residing in Agra city. Materials and Methods: A cross-sectional, community-based study was conducted among under 5 years age children, from June 2012 to July 2013 in an urban slum of Agra. Nutritional status was assessed using anthropometry and clinical examination, and classified as per World Health Organization (WHO) 2006 Growth Standards and CIAF. Results: Of the 458 children studied, 42.8% were underweight, 41.9% had stunting, while 22.7% had wasting. However, 60.04% of children were found to be malnourished as per the CIAF. Unlike three conventional anthropometric indicators of malnutrition, CIAF was observed to have a much consistent association with morbidity like diarrhea episodes in past 3 months (odds ratio (OR) = 2.09), acute respiratory tract infection (ARI) episode in past 3 months (OR = 1.58), and any illness requiring hospitalization (OR = 1.29). Conclusion: The CIAF should supplement the conventional indices of malnourishment, to provide a single, aggregated figure of actual number of undernourished children in a given population. PMID:26435601

  20. Involvement of the eye in protein malnutrition*

    PubMed Central

    McLaren, D. S.

    1958-01-01

    An extensive review of the literature on protein malnutrition, with special reference to the frequency of involvement of the eyes, has been made by the author. Consideration of accounts from all parts of the world and in many different languages, including early as well as more recent descriptions of the syndrome, indicates that this important complication has not received sufficient attention hitherto. The evidence available suggests that it is nearly always an accompanying deficiency of vitamin A that is responsible. Less commonly reported—and producing less severe effects—is deficiency of the B-complex vitamins, and there is no clear evidence to date that protein deficiency itself damages the eyes in these cases. The ways in which protein lack might interfere with various aspects of vitamin-A metabolism are discussed, but it is pointed out that their actual significance in human disease is not yet known. A low dietary intake of vitamin A is regarded by the author as being the prime factor in the causation of eye complications, and attention is drawn to the necessity to correct this as part of any prophylactic or therapeutic programme aimed primarily at combating protein malnutrition. PMID:13585077

  1. To the limit of extreme malnutrition.

    PubMed

    Frølich, Jacob; Palm, Camilla Viola Buskbjerg; Støving, Rene K

    2016-01-01

    Extreme malnutrition with body mass index (BMI) as low as 10 kg/m(2) is not uncommon in anorexia nervosa, with survival enabled through complex metabolic adaptations. In contrast, outcomes from hunger strikes and famines are usually fatal after weight loss to about 40% below expected body weight, corresponding to BMI 12 to 13 kg/m(2) in adults. Thus, many years of adaptation in adolescent-onset anorexia nervosa, supported by supplements of vitamins and treatment of intercurrent diseases, may allow survival at a much lower BMI. However, in the literature only a few cases of survival in patients with BMI <9 kg/m(2) have been described. We report on the case of a 29-y-old woman who was successfully treated in a specialized unit. She had a BMI of 7.8 kg/m(2). To our knowledge, this level of extreme malnutrition has not previously been reported. The present case emphasizes the importance of adherence to guidelines to decrease refeeding complications. PMID:26520917

  2. Not by Bread Alone: Reversing the Effects of Childhood Malnutrition.

    ERIC Educational Resources Information Center

    Carson, David K.; Greeley, Sharon

    1988-01-01

    Investigates three central findings in human malnutrition research: (1) behavioral changes in infants and young children are observable outcomes of malnutrition; (2) non-nutritional factors in the environment affect child development; (3) nutritional supplementation with a consistent and varied regimen of stimulation hold potential for reversing…

  3. Malnutrition among Preschool-Aged Autistic Children in Oman

    ERIC Educational Resources Information Center

    Al-Farsi, Yahya M.; Al-Sharbati, Marwan M.; Waly, Mostafa I.; Al-Farsi, Omar A.; Al Shafaee, Mohammed A.; Deth, Richard C.

    2011-01-01

    To assess prevalence of malnutrition indicators among preschool children with autism spectrum disorder (ASD) a cross-sectional study was conducted among 128 Omani autistic children 3-5 years of age. Based on standardized z-scores, the overall prevalence of malnutrition was 9.2 per 100 preschool ASD children (95% CI 4.1, 11.6). The most common type…

  4. Is malnutrition a problem for multiple sclerosis patients?

    PubMed

    Sorgun, Mine Hayriye; Yucesan, Canan; Tegin, Cuneyt

    2014-09-01

    Nutritional problems associated with multiple sclerosis (MS) have been observed in a number of studies and case reports. However, the prevalence of malnutrition in MS patients is currently unknown. The primary aim of this study was to assess the prevalence of malnutrition in MS patients and to compare the frequency of malnutrition in MS to that of other diseases. The second aim of the study was to determine whether malnutrition was associated with MS type, disease duration or disability status in MS patients. One hundred two MS patients were included in the current study. The control group consisted of 50 patients with other chronic neurological diseases. Neurological examination scores, Kurtzke Functional System Scale scores, serum albumin levels, sedimentation rate and C reactive protein (CRP) were recorded for all patients. Chronic malnutrition was defined as serum albumin levels below 3.5 g/dl with normal sedimentation rate and CRP levels. Twelve MS patients and one control patient were diagnosed with chronic malnutrition, but the difference was not statistically significant (p=0.062). In the MS group, MS type, disease duration, number of attacks, Expanded Disability State Score and Functional System Scale scores were not significantly different regardless of patients' serum albumin levels. We found malnutrition was more prevalent in MS patients than in other chronic diseases. Malnutrition in MS patients was independent of disease course, disease duration, number of attacks, disability status and functional system involvement. These results should be confirmed with further prospective studies in larger MS populations from several facilities. PMID:24932588

  5. Malnutrition and School Feeding. Bulletin, 1921, No. 37

    ERIC Educational Resources Information Center

    Gebhart, John C.

    1922-01-01

    Malnutrition is a term used to indicate a general condition of less than normal physical and mental vigor. While the causes of malnutrition are many, incorrect or inadequate diet appears all too often as one of the causes. School feeding, which affords not only an opportunity, to supplement the home food supply but also to teach correct food…

  6. Amygdala Hyperactivity in MAM Model of Schizophrenia is Normalized by Peripubertal Diazepam Administration.

    PubMed

    Du, Yijuan; Grace, Anthony A

    2016-09-01

    In addition to prefrontal cortex (PFC) and hippocampus, amygdala may have a role in the pathophysiology of schizophrenia, given its pivotal role in emotion and extensive connectivity with the PFC and hippocampus. Moreover, abnormal activities of amygdala may be related to the anxiety observed in schizophrenia patients and at-risk adolescents. These at-risk subjects demonstrated heightened levels of anxiety, which are correlated with the onset of psychosis later in life. Similarly, rats that received methyl azoxymethanol acetate (MAM) gestationally exhibited higher levels of anxiety peripubertally. In the current study, the heightened anxiety was also observed in adult MAM animals, as well as higher firing rates of BLA neurons in both peripubertal and adult MAM rats. In addition, the power of BLA theta oscillations of adult MAM rats showed a larger increase in response to conditioned stimuli (CS). We showed previously that administration of the antianxiety drug diazepam during the peripubertal period prevents the hyperdopaminergic state in adult MAM rats. In this study, we found that peripubertal diazepam treatment reduced heightened anxiety, decreased BLA neuron firing rates and attenuated the CS-induced increase in BLA theta power in adult MAM rats, supporting a persistent normalization by this treatment. This study provides a link between BLA hyperactivity and anxiety in schizophrenia model rats and that circumvention of stress may prevent the emergence of pathology in the adult. PMID:27000940

  7. Flight solar calibrations using the Mirror Attenuator Mosaic (MAM): Low scattering mirror

    NASA Technical Reports Server (NTRS)

    Lee, Robert B., III

    1992-01-01

    Measurements of solar radiances reflected from the mirror attenuator mosaic (MAM) were used to calibrate the shortwave portions of the Earth Radiation Budget Experiment (ERBE) thermistor bolometer scanning radiometers. The MAM is basically a low scattering mirror which has been used to attenuate and reflect solar radiation into the fields of view for the broadband shortwave (0.2 to 5 micrometers) and total (0.2 to 50.0+ micrometers) ERBE scanning radiometers. The MAM assembly consists of a tightly packed array of aluminum, 0.3175-cm diameter concave spherical mirrors and field of view limiting baffles. The spherical mirrors are masked by a copper plate, electro-plated with black chrome. Perforations (0.14 centimeter in diameter) in the copper plate serve as apertures for the mirrors. Black anodized aluminum baffles limit the MAM clear field of view to 7.1 degrees. The MAM assemblies are located on the Earth Radiation Budget Satellite (ERBS) and on the National Oceanic and Atmospheric Administration NOAA-9 and NOAA-10 spacecraft. The 1984-1985 ERBS and 1985-1986 NOAA-9 solar calibration datasets are presented. Analyses of the calibrations indicate that the MAM exhibited no detectable degradation in its reflectance properties and that the gains of the shortwave scanners did not change. The stability of the shortwave radiometers indicates that the transmission of the Suprasil W1 filters did not degrade detectably when exposed to Earth/atmosphere-reflected solar radiation.

  8. Structure-function studies of the magnetite-biomineralizing magnetosome-associated protein MamC.

    PubMed

    Nudelman, Hila; Valverde-Tercedor, Carmen; Kolusheva, Sofiya; Perez Gonzalez, Teresa; Widdrat, Marc; Grimberg, Noam; Levi, Hilla; Nelkenbaum, Or; Davidov, Geula; Faivre, Damien; Jimenez-Lopez, Concepcion; Zarivach, Raz

    2016-06-01

    Magnetotactic bacteria are Gram-negative bacteria that navigate along geomagnetic fields using the magnetosome, an organelle that consists of a membrane-enveloped magnetic nanoparticle. Magnetite formation and its properties are controlled by a specific set of proteins. MamC is a small magnetosome-membrane protein that is known to be active in iron biomineralization but its mechanism has yet to be clarified. Here, we studied the relationship between the MamC magnetite-interaction loop (MIL) structure and its magnetite interaction using an inert biomineralization protein-MamC chimera. Our determined structure shows an alpha-helical fold for MamC-MIL with highly charged surfaces. Additionally, the MamC-MIL induces the formation of larger magnetite crystals compared to protein-free and inert biomineralization protein control experiments. We suggest that the connection between the MamC-MIL structure and the protein's charged surfaces is crucial for magnetite binding and thus for the size control of the magnetite nanoparticles. PMID:26970040

  9. Post-Discharge Mortality in Children with Severe Malnutrition and Pneumonia in Bangladesh

    PubMed Central

    Chisti, Mohammod Jobayer; Graham, Stephen M.; Duke, Trevor; Ahmed, Tahmeed; Faruque, Abu Syed Golam; Ashraf, Hasan; Bardhan, Pradip Kumar; Shahid, Abu S. M. S. B.; Shahunja, K. M.; Salam, Mohammed Abdus

    2014-01-01

    Background Post-discharge mortality among children with severe illness in resource-limited settings is under-recognized and there are limited data. We evaluated post-discharge mortality in a recently reported cohort of children with severe malnutrition and pneumonia, and identified characteristics associated with an increased risk of death. Methods Young children (<5 years of age) with severe malnutrition (WHO criteria) and radiographic pneumonia on admission to Dhaka Hospital of icddr,b over a 15-month period were managed according to standard protocols. Those discharged were followed-up and survival status at 12 weeks post-discharge was determined. Verbal autopsy was requested from families of those that died. Results Of 405 children hospitalized with severe malnutrition and pneumonia, 369 (median age, 10 months) were discharged alive with a follow-up plan. Of these, 32 (8.7%) died in the community within 3 months of discharge: median 22 (IQR 9–35) days from discharge to death. Most deaths were reportedly associated with acute onset of new respiratory or gastrointestinal symptoms. Those that died following discharge were significantly younger (median 6 [IQR 3,12] months) and more severely malnourished, on admission and on discharge, than those that survived. Bivariate analysis found that severe wasting on admission (OR 3.64, 95% CI 1.66–7.97) and age <12 months (OR 2.54, 95% CI 1.1–8.8) were significantly associated with post-discharge death. Of those that died in the community, none had attended a scheduled follow-up and care-seeking from a traditional healer was more common (p<0.001) compared to those who survived. Conclusion and Significance Post-discharge mortality was common in Bangladeshi children following inpatient care for severe malnutrition and pneumonia. The underlying contributing factors require a better understanding to inform the potential of interventions that could improve survival. PMID:25225798

  10. Effects of randomized supplementation of methionine or alanine on cysteine and glutathione production during the early phase of treatment of children with edematous malnutrition

    Technology Transfer Automated Retrieval System (TEKTRAN)

    We have shown that a low glutathione concentration and synthesis rate in erythrocytes are associated with a shortage of protein-derived cysteine in children with edematous severe acute malnutrition (SAM). We tested the hypothesis that methionine supplementation may increase protein-derived cysteine ...

  11. Is malnutrition declining? An analysis of changes in levels of child malnutrition since 1980.

    PubMed Central

    de Onis, M.; Frongillo, E. A.; Blössner, M.

    2000-01-01

    Nutritional status is the best global indicator of well-being in children. Although many surveys of children have been conducted since the 1970s, lack of comparability between them has made it difficult to monitor trends in child malnutrition. Cross-sectional data from 241 nationally representative surveys were analysed in a standard way to produce comparable results of low height-for-age (stunting). Multilevel modelling was applied to estimate regional and global trends from 1980 to 2005. The prevalence of stunting has fallen in developing countries from 47% in 1980 to 33% in 2000 (i.e. by 40 million), although progress has been uneven according to regions. Stunting has increased in Eastern Africa, but decreased in South-eastern Asia, South-central Asia and South America; Northern Africa and the Caribbean show modest improvement; and Western Africa and Central America present very little progress. Despite an overall decrease of stunting in developing countries, child malnutrition still remains a major public health problem in these countries. In some countries rates of stunting are rising, while in many others they remain disturbingly high. The data we have presented provide a baseline for assessing progress and help identify countries and regions in need of populationwide interventions. Approaches to lower child malnutrition should be based on successful nutrition programmes and policies. PMID:11100617

  12. A longitudinal study of dental caries in the primary teeth of children who suffered from infant malnutrition.

    PubMed

    Alvarez, J O; Caceda, J; Woolley, T W; Carley, K W; Baiocchi, N; Caravedo, L; Navia, J M

    1993-12-01

    A prospective, four-year longitudinal study of 209 Peruvian children was conducted to evaluate the effect of a single malnutrition episode occurring at infancy (i.e., < 1 year of age) on dental caries in the primary teeth. Children were recruited into the study at age 6-11 months after they had suffered from a malnutrition episode and were thus classified by anthropometry as either: (1) Normal; (2) Wasted (low weight for height); (3) Stunted (low height for age); or (4) Stunted and Wasted (S and W). Eruption of the primary teeth was significantly delayed in all malnourished children; however, the effect of stunting--that is, retarded linear growth--was more pronounced and lasted longer than that of wasting or acute malnutrition (i.e., 2.5 vs. 1.5 years, respectively). By age 4 years, children from group 4 (S and W) showed a significantly higher caries experience in the primary teeth than did those in any of the other three groups. In summary, this longitudinal study has confirmed previous studies in animals and indirect epidemiological evidence which had suggested a cause-effect relationship between early malnutrition and increased dental caries. PMID:8254124

  13. Purification of the M. magneticum strain AMB-1 magnetosome associated protein MamADelta41.

    PubMed

    Zeytuni, Natalie; Zarivach, Raz

    2010-01-01

    Magnetotactic bacteria comprise a diverse group of aquatic microorganisms that are able to orientate themselves along geomagnetic fields. This behavior is believed to aid their search for suitable environments (1). This capability is conferred by the magnetosome, a subcellular organelle that consists of a linear-chain assembly of lipid vesicles each able to biomineralize and enclose a ~50-nm crystal of magnetite or greigite. A principle component of the magnetosome that was shown to be required for the formation of functional vesicles is MamA. MamA is a highly abundant magnetosome-associated protein which is one of the most characterized magnetosome-associated proteins in vivo (2-6). This article focuses on the purification of MamA, which despite being studied in vivo, no clear functional or structural details have been identified for it. Bioinformatics analysis suggested that MamA is a tetra-tricopeptide repeat (TPR) containing protein. TPR is a structural motif found as such or forming part of a bigger fold in a wide range of proteins, it serves as a template for protein-protein interactions and mediates multi-protein complexes (7). TPRs are involved in many crucial tasks in eukaryotic cell organelle processes and many bacterial pathways (8-14). In order to understand MamA, a unique TPR containing protein, highly purified protein is required as a first step. In this article, we present the purification protocol for a stable MamA deletion mutant (MamADelta41) from M. magneticum AMB-1. PMID:20339346

  14. Use of Baculovirus BacMam Vectors for Expression of ABC Drug Transporters in Mammalian Cells

    PubMed Central

    Shukla, Suneet; Schwartz, Candice; Kapoor, Khyati; Kouanda, Abdul

    2012-01-01

    ATP-binding cassette (ABC) drug transporters ABCB1 [P-glycoprotein (Pgp)] and ABCG2 are expressed in many tissues including those of the intestines, the liver, the kidney and the brain and are known to influence the pharmacokinetics and toxicity of therapeutic drugs. In vitro studies involving their functional characteristics provide important information that allows improvements in drug delivery or drug design. In this study, we report use of the BacMam (baculovirus-based expression in mammalian cells) expression system to express and characterize the function of Pgp and ABCG2 in mammalian cell lines. BacMam-Pgp and BacMam-ABCG2 baculovirus-transduced cell lines showed similar cell surface expression (as detected by monoclonal antibodies with an external epitope) and transport function of these transporters compared to drug-resistant cell lines that overexpress the two transporters. Transient expression of Pgp was maintained in HeLa cells for up to 72 h after transduction (48 h after removal of the BacMam virus). These BacMam-baculovirus-transduced mammalian cells expressing Pgp or ABCG2 were used for assessing the functional activity of these transporters. Crude membranes isolated from these cells were further used to study the activity of these transporters by biochemical techniques such as photo-cross-linking with transport substrate and adenosine triphosphatase assays. In addition, we show that the BacMam expression system can be exploited to coexpress both Pgp and ABCG2 in mammalian cells to determine their contribution to the transport of a common anticancer drug substrate. Collectively, these data demonstrate that the BacMam-baculovirus-based expression system can be used to simultaneously study the transport function and biochemical properties of ABC transporters. PMID:22041108

  15. Use of baculovirus BacMam vectors for expression of ABC drug transporters in mammalian cells.

    PubMed

    Shukla, Suneet; Schwartz, Candice; Kapoor, Khyati; Kouanda, Abdul; Ambudkar, Suresh V

    2012-02-01

    ATP-binding cassette (ABC) drug transporters ABCB1 [P-glycoprotein (Pgp)] and ABCG2 are expressed in many tissues including those of the intestines, the liver, the kidney and the brain and are known to influence the pharmacokinetics and toxicity of therapeutic drugs. In vitro studies involving their functional characteristics provide important information that allows improvements in drug delivery or drug design. In this study, we report use of the BacMam (baculovirus-based expression in mammalian cells) expression system to express and characterize the function of Pgp and ABCG2 in mammalian cell lines. BacMam-Pgp and BacMam-ABCG2 baculovirus-transduced cell lines showed similar cell surface expression (as detected by monoclonal antibodies with an external epitope) and transport function of these transporters compared to drug-resistant cell lines that overexpress the two transporters. Transient expression of Pgp was maintained in HeLa cells for up to 72 h after transduction (48 h after removal of the BacMam virus). These BacMam-baculovirus-transduced mammalian cells expressing Pgp or ABCG2 were used for assessing the functional activity of these transporters. Crude membranes isolated from these cells were further used to study the activity of these transporters by biochemical techniques such as photo-cross-linking with transport substrate and adenosine triphosphatase assays. In addition, we show that the BacMam expression system can be exploited to coexpress both Pgp and ABCG2 in mammalian cells to determine their contribution to the transport of a common anticancer drug substrate. Collectively, these data demonstrate that the BacMam-baculovirus-based expression system can be used to simultaneously study the transport function and biochemical properties of ABC transporters. PMID:22041108

  16. A magnetosome-associated cytochrome MamP is critical for magnetite crystal growth during the exponential growth phase.

    PubMed

    Taoka, Azuma; Eguchi, Yukako; Mise, Shingo; Oestreicher, Zachery; Uno, Fumio; Fukumori, Yoshihiro

    2014-09-01

    Magnetotactic bacteria use a specific set of conserved proteins to biomineralize crystals of magnetite or greigite within their cells in organelles called magnetosomes. Using Magnetospirillum magneticum AMB-1, we examined one of the magnetotactic bacteria-specific conserved proteins named MamP that was recently reported as a new type of cytochrome c that has iron oxidase activity. We found that MamP is a membrane-bound cytochrome, and the MamP content increases during the exponential growth phase compared to two other magnetosome-associated proteins on the same operon, MamA and MamK. To assess the function of MamP, we overproduced MamP from plasmids in wild-type (WT) AMB-1 and found that during the exponential phase of growth, these cells contained more magnetite crystals that were the same size as crystals in WT cells. Conversely, when the heme c-binding motifs within the mamP on the plasmid was mutated, the cells produced the same number of crystals, but smaller crystals than in WT cells during exponential growth. These results strongly suggest that during the exponential phase of growth, MamP is crucial to the normal growth of magnetite crystals during biomineralization. PMID:25048532

  17. Malnutrition in South Asia-A Critical Reappraisal.

    PubMed

    Akhtar, Saeed

    2016-10-25

    Malnutrition continues to be a major public health challenge especially in South Asian developing countries. The aim of the present review is to spotlight the magnitude of the prevalence of malnutrition and its dynamics in South Asian region and to suggest potential approaches for the prevention and control of this issue of public health significance. An extensive review of literature, covering malnutrition and its determinants, health and economic consequences and pragmatic preventive strategies was performed on computer based bibliographic databases (PubMed, Google Scholar, Scopus, Medline and Sciencedirect.com ) to retrieve abstracts and full texts for India, Pakistan, Bangladesh, Sri Lanka and Nepal. All relevant titles and abstracts were examined and evaluated for malnutrition and its prevalence in South Asia. The results revealed malnutrition to be a major public health problem and a potential cause of high disease burden and mortality in South Asia. Compelling evidence suggests malnutrition to be the leading cause of stunting, wasting and underweight with drastic economic consequences among vulnerable populations. Reduced cognitive performance and low productivity have also been associated with micronutrients malnutrition. Suboptimal breastfeeding, inadequate food supply, micronutrient deficiencies, low household income, poor health care system, increased healthcare costs, illiteracy, unhygienic and substandard living, inappropriate child's care and the caregiver, food insecurity and on top of that vicious cycle of poverty, have been recognized as principal indicators for growing malnutrition prevalence in South Asia. Global organizations, local governments, program managers, NGOs, academia, industry in particular and the society at large need to take up the challenge to completely confiscate malnutrition from the region for economic prosperity and a healthier future. PMID:25830938

  18. Thyroid hormones in conditions of chronic malnutrition. A study with special reference to cancer cachexia.

    PubMed Central

    Persson, H; Bennegård, K; Lundberg, P A; Svaninger, G; Lundholm, K

    1985-01-01

    Circulating levels of thyroid hormones (T4, free T4, T3) and reverse tri-iodo thyronine (rT3) and thyroid-hormone binding globulin were related to the nutritional state of patients with cancer cachexia, patients with malnutrition due to other reasons and to well-nourished patients with acute illness. Hospitalized weight-stable and well-nourished patients served as controls. Malnourished patients with or without cancer and acutely ill patients had a low T3 syndrome involving both peripheral metabolism of thyroid hormones and the hypothalamus-pituitary-thyroid gland axis. T3 levels were correlated to altered protein metabolism and protein nutritional state. There were pronounced elevations of circulating rT3 concentrations in patients with serum albumin concentration less than 35 g/l irrespective of diagnosis. The results indicate that the low T3 syndrome in our patients is secondary to insufficient caloric intake. It seems to be maintained by the abnormal nutritional state and is related closely to protein metabolism. The authors found no differences between the low T3 syndrome in cancer patients suffering from cachexia compared with that of patients with malnutrition caused by other factors. PMID:3917657

  19. Jejunal disaccharidases in protein energy malnutrition and recovery.

    PubMed

    Mehra, R; Khambadkone, S M; Jain, M K; Ganapathy, S

    1994-11-01

    The jejunal disaccharidases, sucrase, maltase and lactase, were determined in jejunal biopsies obtained from 43 malnourished children and 10 controls. In the study group, 63% were girls and 93% had severe malnutrition. Lactase activity was significantly reduced in third and fourth degree malnutrition (p < 0.05 and p < 0.005, respectively), but maltase activity was significantly reduced only in the fourth degree malnutrition (p < 0.01). After recovery, maltase and sucrase activities showed a marginally significant increase (p = 0.06), where lactase showed no significant increase (p > 0.05). We conclude that jejunal disaccharidase activity decreases significantly with increasing severity of malnutrition, lactase being the most severely affected and the last to recover. PMID:7896332

  20. Early Childhood Education: The Biological Bases: Malnutrition and Behavioral Development

    ERIC Educational Resources Information Center

    Read, Merrill S.

    1972-01-01

    Malnutrition, contrasted with hunger, is defined as a state of impaired functional ability or development resulting from an inadequate supply of essential nutrients or calories to meet long-term biologic needs. (Author/MB)

  1. Rapid increase in fibroblast growth factor 21 in protein malnutrition and its impact on growth and lipid metabolism.

    PubMed

    Ozaki, Yori; Saito, Kenji; Nakazawa, Kyoko; Konishi, Morichika; Itoh, Nobuyuki; Hakuno, Fumihiko; Takahashi, Shin-Ichiro; Kato, Hisanori; Takenaka, Asako

    2015-11-14

    Protein malnutrition promotes hepatic steatosis, decreases insulin-like growth factor (IGF)-I production and retards growth. To identify new molecules involved in such changes, we conducted DNA microarray analysis on liver samples from rats fed an isoenergetic low-protein diet for 8 h. We identified the fibroblast growth factor 21 gene (Fgf21) as one of the most strongly up-regulated genes under conditions of acute protein malnutrition (P<0·05, false-discovery rate<0·001). In addition, amino acid deprivation increased Fgf21 mRNA levels in rat liver-derived RL-34 cells (P<0·01). These results suggested that amino acid limitation directly increases Fgf21 expression. FGF21 is a polypeptide hormone that regulates glucose and lipid metabolism. FGF21 also promotes a growth hormone-resistance state and suppresses IGF-I in transgenic mice. Therefore, to determine further whether Fgf21 up-regulation causes hepatic steatosis and growth retardation after IGF-I decrease in protein malnutrition, we fed an isoenergetic low-protein diet to Fgf21-knockout (KO) mice. Fgf21-KO did not rescue growth retardation and reduced plasma IGF-I concentration in these mice. Fgf21-KO mice showed greater epididymal white adipose tissue weight and increased hepatic TAG and cholesterol levels under protein malnutrition conditions (P<0·05). Overall, the results showed that protein deprivation directly increased Fgf21 expression. However, growth retardation and decreased IGF-I were not mediated by increased FGF21 expression in protein malnutrition. Furthermore, FGF21 up-regulation rather appears to have a protective effect against obesity and hepatic steatosis in protein-malnourished animals. PMID:26330054

  2. Food insecurity and malnutrition in Chinese elementary school students.

    PubMed

    Shen, Xiuhua; Gao, Xiang; Tang, Wenjing; Mao, Xuanxia; Huang, Jingyan; Cai, Wei

    2015-09-28

    It has been shown that food insecurity is associated with poor diet quality and unfavourable health outcomes. However, little is known about the potential effects of food insecurity on the overall malnutrition status among children. In this study, we investigated the prevalence of food insecurity among 1583 elementary school students, aged 6-14 years, living in Chinese rural areas and examined its association with four malnutrition signs, including rickets sequelae, anaemia, stunting and wasting. Information on food security was collected via questionnaires. Rickets sequelae were assessed by an experienced paediatrician during the interview. Anaemia was determined by the WHO Hb thresholds adjusted by the local altitude. Weight and height were measured during the interview. Stunting and wasting were then evaluated according to WHO child growth standards (2007). We examined the association between food insecurity and the number of malnutrition signs (total number = 4), and the likelihood of having severe malnutrition (presence of 3+ signs), after adjusting for potential confounders, such as age, social-economic status and dietary intakes. During the previous 12 months, the overall prevalence of food insecurity was 6.1% in the entire studied population and 16.3% in participants with severe malnutrition. Participants with food insecurity had a slightly higher number of malnutrition signs (1.14 v. 0.96; P=0.043) relative to those who were food secure, after adjusting for potential confounders. Food insecurity was also associated with increased likelihood of having severe malnutrition (adjusted OR 3.08; 95% CI 1.47, 6.46; P=0.003). In conclusion, food insecurity is significantly associated with malnutrition among Chinese children in this community. PMID:26283622

  3. Visualization of Iron-Binding Micelles in Acidic Recombinant Biomineralization Protein, MamC

    SciTech Connect

    Kashyap, Sanjay; Woehl, Taylor; Valverde-Tercedor, Carmen; Sanchez-Quesada, Miguel; Lopez, Concepcion Jimenez; Prozorov, Tanya

    2014-03-07

    Biological macromolecules are utilized in low-temperature synthetic methods to exert precise control over nanoparticle nucleation and placement. They enable low-temperature formation of a variety of functional nanostructured materials with properties often not achieved via conventional synthetic techniques. Here we report on the in situ visualization of a novel acidic bacterial recombinant protein, MamC, commonly present in the magnetosome membrane of several magnetotactic bacteria, including Magnetococcus marinus, strain MC-1. Our findings provide an insight into the self-assembly of MamC and point to formation of the extended protein surface, which is assumed to play an important role in the formation of biotemplated inorganic nanoparticles. The self-organization of MamC is compared to the behavior of another acidic recombinant iron-binding protein, Mms6.

  4. Mam33 promotes cytochrome c oxidase subunit I translation in Saccharomyces cerevisiae mitochondria

    PubMed Central

    Roloff, Gabrielle A.; Henry, Michael F.

    2015-01-01

    Three mitochondrial DNA–encoded proteins, Cox1, Cox2, and Cox3, comprise the core of the cytochrome c oxidase complex. Gene-specific translational activators ensure that these respiratory chain subunits are synthesized at the correct location and in stoichiometric ratios to prevent unassembled protein products from generating free oxygen radicals. In the yeast Saccharomyces cerevisiae, the nuclear-encoded proteins Mss51 and Pet309 specifically activate mitochondrial translation of the largest subunit, Cox1. Here we report that Mam33 is a third COX1 translational activator in yeast mitochondria. Mam33 is required for cells to adapt efficiently from fermentation to respiration. In the absence of Mam33, Cox1 translation is impaired, and cells poorly adapt to respiratory conditions because they lack basal fermentative levels of Cox1. PMID:26108620

  5. Visualization of Iron-Binding Micelles in Acidic Recombinant Biomineralization Protein, MamC

    DOE PAGESBeta

    Kashyap, Sanjay; Woehl, Taylor; Valverde-Tercedor, Carmen; Sánchez-Quesada, Miguel; Jiménez López, Concepción; Prozorov, Tanya

    2014-01-01

    Biological macromolecules are utilized in low-temperature synthetic methods to exert precise control over nanoparticle nucleation and placement. They enable low-temperature formation of a variety of functional nanostructured materials with properties often not achieved via conventional synthetic techniques. Here we report on the in situ visualization of a novel acidic bacterial recombinant protein, MamC, commonly present in the magnetosome membrane of several magnetotactic bacteria, including Magnetococcus marinus , strain MC-1. Our findings provide an insight into the self-assembly of MamC and point to formation of the extended protein surface, which is assumed to play an important role in the formationmore » of biotemplated inorganic nanoparticles. The self-organization of MamC is compared to the behavior of another acidic recombinant iron-binding protein, Mms6.« less

  6. Malnutrition in alcoholic and virus-related cirrhosis.

    PubMed

    Caregaro, L; Alberino, F; Amodio, P; Merkel, C; Bolognesi, M; Angeli, P; Gatta, A

    1996-04-01

    The study aimed to define the prevalence, characteristics, and clinical importance of nutritional disorders in patients with liver cirrhosis. Nutritional status was evaluated in 120 hospitalized patients--77 with alcoholic and 43 with virus-related cirrhosis--by anthropometric, visceral, and immunologic measurements. Energy malnutrition, defined as triceps skinfold thickness (TSF) and/or midarm muscle circumference (MAMC) below the 5th percentile of standard values, was found in 34% of the study population. Patients below the 5th percentile for MAMC and/or TSF showed significantly lower survival rates at e, 6, 12, and 24 mo compared with patients above the 5th percentile. Protein malnutrition (low albumin, transthyretin, transferrin, and retinol-binding-protein concentrations) and immunoincompetence (abnormal response to skin tests) were much more frequent (81% and 59%) than energy malnutrition (34%). Serum proteins correlated with the degree of liver function impairment, but not with immunologic tests. The prevalence, characteristics, and severity of protein-energy malnutrition were comparable in alcoholic and viral cirrhosis. Malnutrition was correlated with the clinical severity of the liver disease. The study shows that protein-energy malnutrition is a common complication of liver cirrhosis. Nutritional disorders appear to be related to the degree of liver injury rather than to its etiology. Compared with other methods, which have important limitations in liver disease, anthropometry is currently the most reliable method for nutritional assessment in clinical practice and may be valuable for predicting survival in cirrhotic patients. PMID:8599326

  7. Malnutrition, menarche, and marriage in rural Bangladesh.

    PubMed

    Chowdhury, A K; Huffman, S L; Curlin, G T

    1977-01-01

    In order to assess the impact of nutritional status on the onset of menarche and the association between age at menarche and age at marriage, a survey of 1155 girls, ages 10 through 20, was conducted in a rural area of Bangladesh in March 1976. In order to obtain an estimated mean of age of menarche, probit analysis was used. The mean age of menarche using this technique is estimated at 15.65 for Muslims and 15.91 for Hindus. It was learned that in recent years the age of menarche has increased in a rural area. This increase seems to be associated with malnutrition caused by the war, postwar inflation, floods and famines during the 1971-75 period. When age is controlled for, the prominent effect of weight on menstrual status is evident. 98% of the girls whose weights were 88 pounds or greater had reached menarche compared to only 1% of those weighing less than 66 pounds. Body weight appears to be 1 of the most important factors for the determination of onset of menarche. There exists a seasonality of onset of menarche with a peak in winter. Age of marriage among this rural population has increased and may be associated with the increasing age of menarche. Since both age of menarche and age of marriage have increased, fertility among females age 15-19 may be expected to decrease in the future if this pattern continues. PMID:607404

  8. Urinary arsenic concentration adjustment factors and malnutrition.

    PubMed

    Nermell, Barbro; Lindberg, Anna-Lena; Rahman, Mahfuzar; Berglund, Marika; Persson, Lars Ake; El Arifeen, Shams; Vahter, Marie

    2008-02-01

    This study aims at evaluating the suitability of adjusting urinary concentrations of arsenic, or any other urinary biomarker, for variations in urine dilution by creatinine and specific gravity in a malnourished population. We measured the concentrations of metabolites of inorganic arsenic, creatinine and specific gravity in spot urine samples collected from 1466 individuals, 5-88 years of age, in Matlab, rural Bangladesh, where arsenic-contaminated drinking water and malnutrition are prevalent (about 30% of the adults had body mass index (BMI) below 18.5 kg/m(2)). The urinary concentrations of creatinine were low; on average 0.55 g/L in the adolescents and adults and about 0.35 g/L in the 5-12 years old children. Therefore, adjustment by creatinine gave much higher numerical values for the urinary arsenic concentrations than did the corresponding data expressed as microg/L, adjusted by specific gravity. As evaluated by multiple regression analyses, urinary creatinine, adjusted by specific gravity, was more affected by body size, age, gender and season than was specific gravity. Furthermore, urinary creatinine was found to be significantly associated with urinary arsenic, which further disqualifies the creatinine adjustment. PMID:17900556

  9. Immunosuppressive mechanisms in protein-calorie malnutrition

    SciTech Connect

    Redmond, H.P.; Shou, J.; Kelly, C.J.; Schreiber, S.; Miller, E.; Leon, P.; Daly, J.M. )

    1991-08-01

    Protein-calorie malnutrition (PCM) induces immunosuppression leading to increased mortality rates. Impaired macrophage respiratory burst activity (superoxide anion (O2-) generation) occurs in PCM, but cellular mechanisms are unclear. The major pathway resulting in O2- production involves inositol lipid-dependent signal transduction. This study examined the effect of mild versus severe PCM on macrophage O2- generating signal transduction pathways specific for responses to Candida albicans. Mice (CFW/Swiss Webster: n = 300) were randomized to either control or low protein diets for 3 or 8 weeks. Peritoneal macrophages were harvested for O2- production, mannose-fucose receptor (MFR) expression, membrane phospholipid analysis, arachidonic acid (AA) content, prostaglandin E2 (PGE2) production, and protein kinase C levels. O2- release was impaired in both mild and severe PCM. MFR expression was also decreased at these time points. Inositol lipid content was significantly lower at the 8-week time point only, although PGE2 and AA were significantly higher in the low protein diet group at 3 weeks. Protein kinase C levels were unchanged by PCM. Thus, mild PCM significantly increases macrophage-PGE2 production secondary to increased AA phospholipid content, with subsequent inhibition of O2- and MFR expression. Severe PCM inhibits macrophage (O2-) through depletion of critical membrane phospholipid components with subsequent impairment in signal transduction.

  10. Analysis in Outline of Mam, a Mayan Language. Working Paper of the Language Behavior Research Laboratory, No. 25.

    ERIC Educational Resources Information Center

    Canger, Una R.

    The primary goal of the present study is an exposition of the structure of Mam, a Mayan language of the Mamean group. Mam is the most widely spoken of the four Mamean languages, and has been roughly estimated to have a quarter million speakers located in the departments of Huehuetenango and San Marcos in Guatemala and in the state of Chiapas in…

  11. Current and potential role of specially formulated foods and food supplements for preventing malnutrition among 6- to 23-month-old children and for treating moderate malnutrition among 6- to 59-month-old children.

    PubMed

    de Pee, Saskia; Bloem, Martin W

    2009-09-01

    Reducing child malnutrition requires nutritious food, breastfeeding, improved hygiene, health services, and (prenatal) care. Poverty and food insecurity seriously constrain the accessibility of nutritious diets that have high protein quality, adequate micronutrient content and bioavailability, macrominerals and essential fatty acids, low antinutrient content, and high nutrient density. Diets based largely on plant sources with few animal-source and fortified foods do not meet these requirements and need to be improved by processing (dehulling, germinating, fermenting), fortification, and adding animal-source foods, e.g., milk, or other specific nutrients. Options include using specially formulated foods (fortified blended foods, commercial infant cereals, or ready-to-use foods [RUFs; pastes, compressed bars, or biscuits]) or complementary food supplements (micronutrient powders or powdered complementary food supplements containing micronutrients, protein, amino acids, and/or enzymes or lipid-based nutrient supplements (120 to 250 kcal/day), typically containing milk powder, high-quality vegetable oil, peanut paste, sugar, and micronutrients. Most supplementary feeding programs for moderately malnourished children supply fortified blended foods, such as corn-soy blend, with oil and sugar, which have shortcomings, including too many antinutrients, no milk (important for growth), suboptimal micronutrient content, high bulk, and high viscosity. Thus, for feeding young or malnourished children, fortified blended foods need to be improved or replaced. Based on success with ready-to-use therapeutic foods (RUTFs) for treating severe acute malnutrition, modifying these recipes is also considered. Commodities for reducing child malnutrition should be chosen on the basis of nutritional needs, program circumstances, availability of commodities, and likelihood of impact. Data are urgently required to compare the impact of new or modified commodities with that of current

  12. Update on the prevalence of malnutrition among children in Asia.

    PubMed

    Khor, Geok Lin

    2003-12-01

    Approximately 70.0% of the world's malnourished children live in Asia, resulting in the region having the highest concentration of childhood malnutrition. About half of the preschool children are malnourished ranging from 16.0% in the People's Republic of China to 64.0% in Bangladesh. Prevalence of stunting and underweight are high especially in South Asia where one in every two preschool children is stunted. Besides protein-energy malnutrition, Asian children also suffer from micronutrient deficiency. Iron deficiency anaemia affects 40.0-50.0% of preschool and primary school children. Nearly half of all vitamin A deficiency and xeropthalmia in the world occurs in South and Southeast Asia, with large numbers of cases in India (35.3 million), Indonesia (12.6 million) and China (11.4 million). Another major micronutrient problem in the region is iodine deficiency disorders, which result in high goiter rates as manifested in India, Pakistan and parts of Indonesia. While under-nutrition problem persists, overweight problem in children has emerged in Asia, including Taiwan, Singapore and urban China and Malaysia. The etiology of childhood malnutrition is complex involving interactions of multiple determinants that include biological, cultural and socio-economic influences. Protein-energy malnutrition and micronutrient deficiency leading to early growth failure often can be traced to poor maternal nutritional and health care before and during pregnancy, resulting in intrauterine growth retardation and children born with low birth weight. While significant progress has been achieved over the past 30 years in reducing the proportion of malnourished children in developing countries, nonetheless, malnutrition persists affecting large numbers of children. The socio-economic cost of the malnutrition burden to the individual, family and country is high resulting in lower cognitive outcomes in children and lower adult productivity. Interventions that are cost-effective and

  13. Nutrition support and malnutrition in Nigeria.

    PubMed

    Ojofeitimi, E O; Smith, I F

    1988-12-01

    In 1983, a nutritional support team was formed at the University of Ife-Ife, Nigeria, that used high calorie enteral mixtures successfully for dietary management of protein energy malnutrition (PEM) in children. PEM has several causes. Poverty is often cited, but the incidence of mild to severe PEM in children under 5 is higher in the Ivory Coast, Nigeria, Egypt and Sudan with per capita gross national product (GNP) above $400 than in Sierra Leone, India, Uganda, and Kenya with GNP below this amount. The consumption of legumes and oil seeds ward off kwashiorkor and marasmus, but in countries with traditional food practices they are not consumed in adequate amounts. Beans, groundnuts, melon seeds, and soya beans are cheap and produced in African and Asian countries. In Nigeria the traditional weaning food is a thin gruel made from maize, sorghum, or millet. Milk, groundnut paste, or sugar is not added. Legumes and other oil seeds are forbidden for children because of deep-rooted cultural practices that favor tubers. Longer duration of breast feeding protects infants from kwashiorkor or marasmus, but the recent drastic change in the pattern with early introduction of artificial feeding has resulted in early appearance of kwashiorkor or gastroenteritis. Low literacy of mothers is another factor, and it inversely correlated with infant mortality. The increase in the level of female literacy and maternal education in less developed countries is a major requirement from governments if they are to combat harmful food taboos. Since Williams associated maize diets with kwashiorkor in 1933, research has show energy deficiency more perilous than protein insufficiency in the treatment and prevention of PEM in these countries. PMID:3145401

  14. Detailed characterization of the O-linked glycosylation of the neuropilin-1 c/MAM-domain.

    PubMed

    Windwarder, Markus; Yelland, Tamas; Djordjevic, Snezana; Altmann, Friedrich

    2016-06-01

    Neuropilins are involved in angiogenesis and neuronal development. The membrane proximal domain of neuropilin-1, called c or MAM domain based on its sequence conservation, has been implicated in neuropilin oligomerization required for its function. The c/MAM domain of human neuropilin-1 has been recombinantly expressed to allow for investigation of its propensity to engage in molecular interactions with other protein or carbohydrate components on a cell surface. We found that the c/MAM domain was heavily O-glycosylated with up to 24 monosaccharide units in the form of disialylated core 1 and core 2 O-glycans. Attachment sites were identified on the chymotryptic c/MAM peptide ETGATEKPTVIDSTIQSEFPTY by electron-transfer dissociation mass spectrometry (ETD-MS/MS). For highly glycosylated species consisting of carbohydrate to about 50 %, useful results could only be obtained upon partial desialylation. ETD-MS/MS revealed a hierarchical order of the initial O-GalNAc addition to the four different glycosylation sites. These findings enable future functional studies about the contribution of the described glycosylations in neuropilin-1 oligomerization and the binding to partner proteins as VEGF or galectin-1.As a spin-off result the sialidase from Clostridium perfringens turned out to discriminate between galactose- and N-acetylgalactosamine-linked sialic acid. PMID:26059692

  15. Some Considerations on {sup 242m}Am Production in Thermal Reactors

    SciTech Connect

    Cesana, Alessandra; Mongelli, Sara Tania; Terrani, Mario; Benetti, Pietro; Calligarich, Elio; Dolfini, Rinaldo; Raselli, Gian Luca

    2004-10-15

    Recently, it has been suggested to consider {sup 242m}Am as a potential nuclear fuel. This artificial nuclide can be produced through {sup 241}Am neutron capture carried on in a neutron field typical of a thermal reactor. In order to suppress the thermal neutron flux, which will cause {sup 242m}Am depletion mainly through fission, proper neutron filters should be adopted. In a very intense neutron field, the {sup 242m}Am enrichment depends mainly on the energy distribution of the neutrons, the sample thickness, and the cutoff energy of the neutron filter.An investigation on different geometries of the sample to be irradiated using Cd, B, Sm, and Gd as neutron filters has been carried out by means of Monte Carlo simulation. The most favorable results have been obtained irradiating thin {sup 241}Am samples (11 {mu}g/cm{sup 2}) covered with a Gd (0.2-mm-thick) or Sm (1-mm-thick) filter. In these cases the theoretical {sup 242m}Am enrichment can reach 20%.The preparation of significant quantities of this unconventional nuclear fuel implies isotopic separation techniques operating in high radioactive environments and hopefully characterized by very high recovery factors, which are in no way trivial problems.

  16. Improving best-phase image quality in cardiac CT by motion correction with MAM optimization

    SciTech Connect

    Rohkohl, Christopher; Bruder, Herbert; Stierstorfer, Karl; Flohr, Thomas

    2013-03-15

    Purpose: Research in image reconstruction for cardiac CT aims at using motion correction algorithms to improve the image quality of the coronary arteries. The key to those algorithms is motion estimation, which is currently based on 3-D/3-D registration to align the structures of interest in images acquired in multiple heart phases. The need for an extended scan data range covering several heart phases is critical in terms of radiation dose to the patient and limits the clinical potential of the method. Furthermore, literature reports only slight quality improvements of the motion corrected images when compared to the most quiet phase (best-phase) that was actually used for motion estimation. In this paper a motion estimation algorithm is proposed which does not require an extended scan range but works with a short scan data interval, and which markedly improves the best-phase image quality. Methods: Motion estimation is based on the definition of motion artifact metrics (MAM) to quantify motion artifacts in a 3-D reconstructed image volume. The authors use two different MAMs, entropy, and positivity. By adjusting the motion field parameters, the MAM of the resulting motion-compensated reconstruction is optimized using a gradient descent procedure. In this way motion artifacts are minimized. For a fast and practical implementation, only analytical methods are used for motion estimation and compensation. Both the MAM-optimization and a 3-D/3-D registration-based motion estimation algorithm were investigated by means of a computer-simulated vessel with a cardiac motion profile. Image quality was evaluated using normalized cross-correlation (NCC) with the ground truth template and root-mean-square deviation (RMSD). Four coronary CT angiography patient cases were reconstructed to evaluate the clinical performance of the proposed method. Results: For the MAM-approach, the best-phase image quality could be improved for all investigated heart phases, with a maximum

  17. Methamphetamine use and malnutrition among street-involved youth

    PubMed Central

    2010-01-01

    We sought to explore the effect of crystal methamphetamine use on the risk of experiencing malnutrition among street-involved youth in Vancouver, Canada. Risk of malnutrition was defined as being hungry but not having enough money to buy food. Socio-demographic and drug use factors associated with risk of malnutrition were investigated using univariate and multivariate analysis among a prospective cohort of street-involved youth known as the At-Risk Youth Study (ARYS). Between September 2005 and December 2006, 509 street-involved youth were enrolled in ARYS, among whom 21% reported being at risk of malnutrition as defined above in the previous six months. In multivariate analysis, only non-injection crystal methamphetamine was significantly associated with being at risk of malnutrition among this cohort (Adjusted Odds Ratio [AOR] = 1.60, 95% Confidence Interval [CI]: 1.03 - 2.48, p = 0.036). Interventions seeking to address food insecurity among street youth may benefit from considering drug use patterns since methamphetamine use predicted higher risk in this setting. PMID:20210992

  18. Progressive Changes in the Plasma Metabolome during Malnutrition in Juvenile Pigs.

    PubMed

    Jiang, Pingping; Stanstrup, Jan; Thymann, Thomas; Sangild, Per Torp; Dragsted, Lars Ove

    2016-02-01

    Severe acute malnutrition (SAM) is one of the leading nutrition-related causes of death in children under five years of age. The clinical features of SAM are well documented, but a comprehensive understanding of the development from a normal physiological state to SAM is lacking. Characterizing the temporal metabolomic change may help to understand the disease progression and to define nutritional rehabilitation strategies. Using a piglet model we hypothesized that a progressing degree of malnutrition induces marked plasma metabolite changes. Four-week-old weaned pigs were fed a nutrient-deficient maize diet (MAL) or nutritionally optimized reference diet (REF) for 7 weeks. Plasma collected weekly was subjected to LC-MS for a nontargeted profiling of metabolites with abundance differentiation. The MAL pigs showed markedly reduced body-weight gain and lean-mass proportion relative to the REF pigs. Levels of eight essential and four nonessential amino acids showed a time-dependent deviation in the MAL pigs from that in the REF. Choline metabolites and gut microbiomic metabolites generally showed higher abundance in the MAL pigs. The results demonstrated that young malnourished pigs had a profoundly perturbed metabolism, and this provides basic knowledge about metabolic changes during malnourishment, which may be of help in designing targeted therapeutic foods for refeeding malnourished children. PMID:26626656

  19. Six simple questions to detect malnutrition or malnutrition risk in elderly women

    PubMed Central

    Gutiérrez-Gómez, Tranquilina; Cortés, Ernesto; Peñarrieta-de Córdova, Isabel; Gil-Guillén, Vicente Francisco; Ferrer-Diego, Rosa María

    2015-01-01

    Of the numerous instruments available to detect nutritional risk, the most widely used is the Mini Nutritional Assessment (MNA), but it takes 15–20 min to complete and its systematic administration in primary care units is not feasible in practice. We developed a tool to evaluate malnutrition risk that can be completed more rapidly using just clinical variables. Between 2008 and 2013, we conducted a cross-sectional study of 418 women aged ≥60 years from Mexico. Our outcome was positive MNA and our secondary variables included were: physical activity, diabetes mellitus, hypertension, educational level, dentition, psychological problems, living arrangements, history of falls, age and the number of tablets taken daily. The sample was divided randomly into two groups: construction and validation. Construction: a risk table was constructed to estimate the likelihood of the outcome, and risk groups were formed. Validation: the area under the ROC curve (AUC) was calculated and we compared the expected and the observed outcomes. The following risk factors were identified: physical activity, hypertension, diabetes, dentition, psychological problems and living with the family. The AUC was 0.77 (95% CI [0.68–0.86], p < 0.001). No differences were found between the expected and the observed outcomes (p = 0.902). This study presents a new malnutrition screening test for use in elderly women. The test is based on six very simple, quick and easy-to-evaluate questions, enabling the MNA to be reserved for confirmation. However, it should be used with caution until validation studies have been performed in other geographical areas. PMID:26500824

  20. Self-recognition mechanism of MamA, a magnetosome-associated TPR-containing protein, promotes complex assembly.

    PubMed

    Zeytuni, Natalie; Ozyamak, Ertan; Ben-Harush, Kfir; Davidov, Geula; Levin, Maxim; Gat, Yair; Moyal, Tal; Brik, Ashraf; Komeili, Arash; Zarivach, Raz

    2011-08-16

    The magnetosome, a biomineralizing organelle within magnetotactic bacteria, allows their navigation along geomagnetic fields. Magnetosomes are membrane-bound compartments containing magnetic nanoparticles and organized into a chain within the cell, the assembly and biomineralization of magnetosomes are controlled by magnetosome-associated proteins. Here, we describe the crystal structures of the magnetosome-associated protein, MamA, from Magnetospirillum magneticum AMB-1 and Magnetospirillum gryphiswaldense MSR-1. MamA folds as a sequential tetra-trico-peptide repeat (TPR) protein with a unique hook-like shape. Analysis of the MamA structures indicates two distinct domains that can undergo conformational changes. Furthermore, structural analysis of seven crystal forms verified that the core of MamA is not affected by crystallization conditions and identified three protein-protein interaction sites, namely a concave site, a convex site, and a putative TPR repeat. Additionally, relying on transmission electron microscopy and size exclusion chromatography, we show that highly stable complexes form upon MamA homooligomerization. Disruption of the MamA putative TPR motif or N-terminal domain led to protein mislocalization in vivo and prevented MamA oligomerization in vitro. We, therefore, propose that MamA self-assembles through its putative TPR motif and its concave site to create a large homooligomeric scaffold which can interact with other magnetosome-associated proteins via the MamA convex site. We discuss the structural basis for TPR homooligomerization that allows the proper function of a prokaryotic organelle. PMID:21784982

  1. [Evolution of chronic malnutrition in children under five in Peru].

    PubMed

    Sánchez-Abanto, José

    2012-01-01

    Child chronic malnutrition is one of the main problems of Public Health in Peru, according to WHO's reference values, national prevalence is 19.5% in children under five. Child chronic malnutrition has a negative impact on people throughout their lives, limits the development of society and hinders poverty eradication. To attain the goal of reducing chronic malnutrition in children to 10% by 2016, the Peruvian government will continue to strengthen, mainly, the efficient use of economic resources, the assessment of interventions, the implementation of investigations that help define causal relations and provide information for the design of public policies, health capacity building and the articulation of different government levels. This article goes over the main interventions implemented in the country. PMID:23085805

  2. Prosthetic rehabilitation of edentulism prevents malnutrition in nursing home residents.

    PubMed

    Andreas Zenthöfer, Andreas; Rammelsberg, Peter; Cabrera, Tomas; Hassel, Alexander

    2015-01-01

    To investigate the association between prosthetic rehabilitation and malnutrition in institutionalized elders, 255 nursing home residents were recruited for this study and underwent a comprehensive dental examination. The body mass index (BMI) was administered to estimate the nutritional condition. Participants with BMI < 20 kg/mc were categorized as malnourished (n = 33), whereas all others were categorized as adequately nourished (n = 222). The number of teeth present and the prevalence of prosthetic rehabilitation were significantly lower in malnourished participants (P < .05). Malnutrition risk was 4.6 times higher for participants who were edentulous and did not wear dentures. Adequate replacement of teeth is important to prevent malnutrition in institutionalized older people. PMID:25822309

  3. The influence of early malnutrition on subsequent behavioral development III. Learning disabilities as a sequel to malnutrition.

    PubMed

    Galler, J R; Ramsey, F; Solimano, G

    1984-04-01

    The academic performance of 129 Barbadian children (77 boys and 52 girls), who were 5-11-yr-old and suffered moderate to severe protein-energy malnutrition in the first year of life, was compared with the performance of matched comparisons, children who had no history of malnutrition. Children with a history of malnutrition were found to have lower performance on eight out of nine academic subject areas, namely, language arts, mathematics, general science, social science, reading, health, religion, and arts/crafts. Socioeconomic factors in the backgrounds of the children were also examined. A model is presented clarifying the interrelationships of malnutrition, socioeconomic status and school performance. Reduced school performance in the previously malnourished children can be largely accounted for by deficits in classroom behavior, and, to a lesser extent by a reduction in I.Q. Current socioeconomic status is not directly involved in altering academic performance whereas the early history of malnutrition and its accompanying conditions at the time of the illness are leading contributors to altered behavioral outcome and school performance. PMID:6718088

  4. Effects of ethanol and malnutrition on rat neuromotor development.

    PubMed

    Ribeiro-da-Silva, N F; Menezes, A C; Malheiros, L R; da-Silva, V A

    1994-06-01

    The objective of the present study was to determine whether there is a synergistic effect of malnutrition and ethanol exposure on neuromotor development. Ethanol (E) (6 g/kg) or sucrose (S) (isocaloric to ethanol) was administered by gavage to ad libitum-fed (A) and malnourished (M) pregnant rats on days 18, 19 and 20 of pregnancy. Malnutrition was produced by food restriction to 50% of control intake. At birth, the offspring were weighed and transferred to surrogate mothers. Performance in the rim-escape test and on the rotating rod were evaluated on days 19 and 28 of life, respectively. Development of the adult swimming pattern was also studied. The results indicated that: 1) malnutrition alone decreased birth weight (g) significantly (AE, 5.56 +/- 0.36; AS, 6.31 +/- 1.05; ME, 4.81 +/- 0.73; MS, 5.23 +/- 0.57); 2) a synergistic interaction between alcohol exposure and malnutrition was observed only in the rim escape test (percent of falling rats: AE, 9; AS, 5; ME, 24; MS, 5); 3) only malnutrition retarded development of swimming; 4) malnourished dams gained more weight (g) than controls during treatment with ethanol (AE, 2.6 +/- 8.4, N = 6; AS, 3.1 +/- 8.4, N = 4; ME, 23.0 +/- 6.3, N = 7; MS, 29.0 +/- 9.0, N = 8). These results indicate a possible synergistic action between malnutrition and ethanol on neuromotor development and point to the importance of ethanol as a calorie source for malnourished animals. PMID:7894351

  5. Gendered effects of siblings on child malnutrition in South Asia: cross-sectional analysis of demographic and health surveys from Bangladesh, India, and Nepal.

    PubMed

    Raj, Anita; McDougal, Lotus P; Silverman, Jay G

    2015-01-01

    This study examines the effects of number and sex of siblings on malnutrition of boys and girls under-5 in South Asia. Cross-sectional analyses were conducted on Demographic and Health Surveys data on children under-5 in Bangladesh (N = 7,861), India (N = 46,655) and Nepal (N = 2,475). Data were pooled across countries, and multinomial logistic regression was used to assess the relationship between number and sex of siblings and malnutrition outcomes (wasting, stunting, underweight; based on anthropometric data), adjusting for country and key social and maternal-child health indicators in sex stratified analyses. Number of brothers increased the odds for severe wasting [1 vs. 0 brothers adjusted odds ratio (AOR) = 1.31, 95 % CI = 1.11, 1.55; 2 vs. 0 brothers AOR = 1.36, 95 % CI = 1.07, 1.73] for girls but not boys. Having more male siblings and more female siblings increased the odds of stunting for boys and girls, but effect of 3+ sisters on severe stunting was significantly stronger for girls than boys (girls- 3+ vs. 0 sisters AOR = 2.25, 95 % CI = 1.88, 2.70; boys- 3+ vs. 0 sisters AOR = 1.37, 95 % CI = 1.13, 1.67). For underweight, three or more sisters increased the odds for severe underweight for girls (AOR = 1.27, 95 % CI = 1.04, 1.57) but not boys. Having brothers heightens girl risk for acute malnutrition (wasting), where having multiple sisters increases girl risk for chronic malnutrition (stunting/underweight). Boy malnutrition is less affected by siblings. Findings suggest that issues of son preference/daughter aversion may affect child malnutrition in South Asia. PMID:24889112

  6. A Case of Pseudocholinesterase Deficiency Resulting From Malnutrition.

    PubMed

    LaRocca, Christopher J; Beilman, Greg J; Birch, Martin

    2016-09-01

    Pseudocholinesterase deficiencies occur because of both genetic and acquired factors. We present the case of a patient with a history of bariatric surgery and severe malnutrition who subsequently developed prolonged neuromuscular blockade after succinylcholine administration. She had markedly decreased pseudocholinesterase levels at the time of the incident, but her motor function returned to normal with supportive care. After aggressive nutritional support over multiple weeks, her pseudocholinesterase levels drastically improved. For those patients in a poor nutritional state who experience an unexpected episode of apnea or prolonged neuromuscular blockade, practitioners must always consider malnutrition-induced pseudocholinesterase deficiency as a possible etiology. PMID:27467903

  7. Effects of protein-calorie malnutrition and refeeding on fluorouracil toxicity

    SciTech Connect

    Gamelli, R.L.; Foster, R.S. Jr.

    1983-10-01

    Mice were used to study the effects of protein-calorie malnutrition and its reversal on granulocyte-macrophage production and fluorouracil's toxic effect on bone marrow. An in vitro quantitative clonal culture technique for bone marrow granulocyte-macrophage progenitor cells (GM-CFC) was used. Animals on a protein-free but otherwise complete diet for ten days had a significant contraction in total marrow cellularity and GM-CFC numbers paralleling the animal's weight loss. The acute toxic effect of fluorouracil on bone marrow was not increased in protein-deprived animals. On refeeding, there was a biphasic response in the degree of toxic effect on marrow. Animals refed for one day had significantly increased fluorouracil-related marrow abnormalities. However, animals refed for four days, when marrows were repleted, were partially protected from the drug's cytotoxic effects. The increased sensitivity in mice refed for one day was related to more GM-CFC in active DNA synthesis.

  8. Protein - Calorie Malnutrition in Children and its Relation to Psychological Development and Behavior

    ERIC Educational Resources Information Center

    Latham, Michael C.

    1974-01-01

    Encompassing only human and excluding animal studies, this review surveys the literature on protein-calorie malnutrition and its possible role in retarding psychological, intellectual or behavioral development. Areas reviewed include types of protein-calorie malnutrition, the effects of malnutrition on brain development, cross-sectional and…

  9. Circular Migration and Young Child Malnutrition in Guatemala.

    ERIC Educational Resources Information Center

    Teller, Charles H.; Butz, William P.

    This paper examined the relationship between temporary migration and childhood malnutrition in Guatemala and questioned whether migration patterns or low socioeconomic status produced a special risk group. The study emphasized policy implications of high priorities placed on population redistribution in Latin American governments and the…

  10. Interactions between intestinal pathogens, enteropathy and malnutrition in developing countries

    PubMed Central

    Prendergast, Andrew J.; Kelly, Paul

    2016-01-01

    Purpose of review This review focuses on recent data highlighting the interactions between intestinal pathogens, enteropathy and malnutrition in developing countries, which drive morbidity and mortality and hinder the long-term developmental potential of children. Recent findings Diarrhoea remains the second commonest cause of death in children below 5 years, and malnutrition underlies 45% of all child deaths. Even in the absence of diarrhoea, subclinical pathogen carriage and enteropathy are almost universal in developing countries. Here, we review recent studies addressing the causes and consequences of diarrhoea; emerging data on environmental influences that govern postnatal development of the gut and microbiota; current concepts of environmental enteric dysfunction; and recent intervention trials in the field. We highlight the interactions between these processes, whereby intestinal pathogens drive a cycle of gut damage, malabsorption, chronic inflammation and failed mucosal regeneration, leading to malnutrition and susceptibility to further enteric infections. Summary Efforts to improve child survival and long-term developmental potential need to address the overlapping and interacting effects of diarrhoea, enteropathy and malnutrition. Recent insights from human and animal studies suggest potential targets for intervention. PMID:26967147

  11. Host response, malnutrition and oral diseases. Part 1.

    PubMed

    Słotwińska, Sylwia Małgorzata; Słotwiński, Robert

    2014-01-01

    Effective defense response of the body requires the proper nutritional and metabolic preparation and adequate energy expenditure. Every pathological process with coexisting malnutrition is subject to an increased risk of failure and complications in medical treatment, which is a serious threat to human health and life. Malnutrition, particularly protein-calorie malnutrition, is characterized by a decrease in resistance, particularly involving cellular immune deficiency, which in turn causes a significant decrease in resistance to infections. Inflammation is the price that the organism has to pay for the effective antimicrobial defense. Therefore, uncontrolled changes may occur in the immune system in nutrition disorders, especially in a significant protein-calorie malnutrition, which in turn prevents the correct response to microbial infection, including bacterial infection, which occurs in the course of periodontitis or untreated caries disease. Research determining the relationship between the clinical state of oral health, selected immune parameters and indicators of nutritional status of the organism, is an alternative to other attempts undertaken to reduce these risks. PMID:26155172

  12. AIDS and malnutrition: dual assaults on the body.

    PubMed

    Merrill, A

    1995-01-01

    The immune system is impaired by either malnutrition or human immunodeficiency virus infection. When these occur together, their compounding effects promote altered metabolism, inadequate intake, and malabsorption, which further impair immune function and contribute to human immunodeficiency virus wasting. Careful dietary management can help meet nutritional needs without further compromising the immune status of the person living with acquired immune deficiency syndrome. PMID:7860343

  13. Ultrastructure of the adipose tissue matrix in children with malnutrition.

    PubMed

    Alexa, A; Drăgan, M; Popa, I; Raica, M; Dema, E

    1995-01-01

    Bioptic fragments of adipose white tissue taken from trochanterian area from children of 2-22 months old were ultrastructurally investigated. Children were of both sexes, 5 normal and 22 with clinical diagnosis of malnutrition. There were studied many interadipocyte spaces signalling out in cases with malnutrition modifications of different components, some of them related with the degree of malnutrition. There were noted: disorganisation and disappearance of basal membranes of capillaries and glycolema; modifications of endothelial cells with lesions of the capillary wall and free degraded red blood cells; disorganization of the ground substance in small areas or sometimes extended to all matrix of the space; collagen fibres reduced in number and size, and in two cases the presence of collagen fibrils with severe lesions, realeasing an electrondense material, fibrinoid-like; matrix infiltration, in some cases with lipids. In only one interadipocyte space a synaptic button was noted in contact with capillary. In malnutrition lesions of cellular elements of the white adipose tissue the following were observed: adipocytes, fibroblasts, fibrocytes, endothelial cells, mast cells--which in their turn are responsible for modifications of macromolecular structures of the extracellular matrix--glycosaminoglycans, proteoglycans, components of which biosyntheses are cell-dependent. PMID:8772367

  14. Qualitative Study of Malnutrition in People with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Franssen, Janine J. L.; Maaskant, Marian A.; van Schrojenstein Lantman-de Valk, Henny M. J.

    2011-01-01

    The prevalence of underweight status is relatively high in persons with intellectual disabilities. However, it is not clear whether this is due to malnourishment. The authors sought to examine the awareness and knowledge of physicians, dieticians, and direct care staff regarding malnutrition in people with intellectual disabilities. They also…

  15. Relationships of Hunger and Malnutrition to Learning Ability and Behavior.

    ERIC Educational Resources Information Center

    Florida State Dept. of Citrus, Lakeland.

    This survey of scientific literature briefly overviews findings on the relations between learning and behavior and hunger, undernutrition, and malnutrition. Topics examined include chronic undernutrition in the U.S., iron deficiency, obesity, and hyperactivity. School feeding programs, including school breakfast programs, are described. The list…

  16. The need for consistent criteria for identifying malnutrition.

    PubMed

    Hoffer, L John

    2009-01-01

    The lack of consistent criteria for diagnosing malnutrition and protein-energy malnutrition (PEM) creates problems in educating medical students and physicians, setting the parameters for observational and controlled clinical trials, and formulating clinical guidelines. There is no validated formal definition of malnutrition (or PEM), and the tools that have been developed to screen for it, or diagnose it, vary in their agreement. I make the following suggestions. First, avoid unqualified use of the term 'malnutrition', as it is ambiguous. Second, carefully distinguish between screening and diagnosis, which have different aims and implications. Third, consider the notion that in medicine the diagnosis of PEM is reached by 'narrative-interpretive' reasoning, which regards the disease as a pathophysiological entity in a specific clinical context. I recommend that the concept of PEM as a disease (not a score) be imbedded in teaching and the practice of medicine, and in the design of clinical trials and the setting of guidelines. Fourth, disagreements in screening-derived risk scores and uncertainty in diagnosis are difficult to avoid, but only in the grey zone. It would be prudent, at least until the greater medical world considers the nutritional paradigm plausible enough to invest in it, to enroll only patients who have unambiguously diagnosed PEM in prospective trials with hard clinical endpoints. PMID:19858685

  17. What Explains Child Malnutrition of Indigenous People of Northeast India?

    PubMed Central

    Dinachandra Singh, Konsam; Alagarajan, Manoj; Ladusingh, Laishram

    2015-01-01

    Household risk factors affecting child health, particularly malnutrition, are mainly basic amenities like drinking water, toilet facility, housing and fuel used for cooking. This paper considered the collective impact of basic amenities measured by an index specially constructed as the contextual factor of child malnutrition. The contextual factor operates at both the macro and micro levels namely the state level and the household level. The importance of local contextual factors is especially important when studying the nutritional status of children of indigenous people living in remote and inaccessible regions. This study has shown the contextual factors as potential factors of malnutrition among children in northeast India, which is home to the largest number of tribes in the country. In terms of macro level contextual factor it has been found that 8.9 per cent, 3.7 per cent and 3.6 per cent of children in high, medium and low risk households respectively, are severely wasted. Lower micro level household health risks, literate household heads, and scheduled tribe households have a negating effect on child malnutrition. Children who received colostrum feeding at the time of birth and those who were vaccinated against measles are also less subject to wasting compared to other children, and these differences are statistically significant. PMID:26121475

  18. Malnutrition and child feeding practices in Western Samoa.

    PubMed

    Jansen, A A

    1977-12-01

    Mild protein-calorie malnutrition is common in Western Samoa. Severe protein-calorie malnutrition is also an important cause of death in infants and toddlers, and anemia is frequently found in small children. This paper investigates child feeding practices because of its possible relationship with the occurrence of severe early malnutrition. Data on infant and toddler feeding practices were collected from 90 mothers from the town of Apia and 38 mothers from the island is Savai'i. Average age of mothers in Apia was 29.0 years and in Savai'i, 30 years. Most belonged to the low income group. Average interval between births in Apia was 22.3 months, in Savai'i, 25.7 months. The proportion of bottlefed children was much lower in Savai'i than in urban Apia, 28.2 vs. 57.9%. 31.3% of Apian mothers weaned their last child abruptly compared with 41.6% of Savai'i mothers. In Apia, weaning foods consisted of milk, meat, and other protein-rich foods; in Savai'i, taro, orange leaf tea, rice, and other were the main weaning foods. Generally, semisolids were not introduced before the child was more than 6 months of age. Some mothers in Savai'i appeared to give their children monotonous diet. A number of cultural taboos appear to affect the children's diet as well as that of pregnant and lactating mothers. Many women believed in them and would not eat or do certain things. Overall, it appears that many of the mothers are ignorant about the nutritional needs of their children. Almost 7% of the 0-5 year old children suffered from borderline malnutrition. 9% of the total number of admissions during the period October 1968 to April 1972 were malnourished children. The increase in borderline malnutrition and severe malnutrition among the children towards the end of the 1st year is attributed mainly to the late introduction of semisolid and solid foods. Other causes of malnutrition include lack of money, especially in urban areas, large families, changes in the diet because of higher

  19. Cysteines in the neuropilin-2 MAM domain modulate receptor homooligomerization and signal transduction.

    PubMed

    Barton, Rachael; Driscoll, Alyssa; Flores, Samuel; Mudbhari, Durlav; Collins, Theresa; Iovine, M Kathryn; Berger, Bryan W

    2015-07-01

    Neuropilins (NRPs) are transmembrane receptors involved in angiogenesis, lymphangiogenesis, and neuronal development as well as in cancer metastasis. Previous studies suggest that NRPs exist in heteromeric complexes with vascular endothelial growth factors (VEGFs) and VEGF receptors as well as plexins and semaphorins. We determined via site-directed mutagenesis and bioluminescent resonance energy transfer assays that a conserved cysteine (C711) in the Danio rerio NRP2a MAM (meprin, A-5 protein, and protein tyrosine phosphatase μ) domain modulates NRP2a homomeric interactions. Mutation of this residue also disrupts semaphorin-3F binding in NRP2a-transfected COS-7 cells and prevents the NRP2a overexpression effects in a zebrafish vascular model. Collectively, our results indicate the MAM domain plays an important role in defining the NRP2 homodimer structure, which is important for semaphorin-dependent signal transduction via NRP2. PMID:25656526

  20. Model documentation report: Macroeconomic Activity Module (MAM) of the National Energy Modeling System

    SciTech Connect

    1997-02-01

    This report documents the objectives, analytical approach, and development of the National Energy Modeling System (NEMS) Macroeconomic Activity Module (MAM) used to develop the Annual Energy Outlook for 1997 (AEO 97). The report catalogues and describes the module assumptions, computations, methodology, parameter estimation techniques, and mainframe source code. This document serves three purposes. First it is a reference document providing a detailed description of the NEMS MAM used for the AEO 1997 production runs for model analysts, users, and the public. Second, this report meets the legal requirement of the Energy Information Administration (EIA) to provide adequate documentation in support of its models. Third, it facilitates continuity in model development by providing documentation from which energy analysts can undertake model enhancements, data updates, and parameter refinements as future projects.

  1. Model documentation report: Macroeconomic Activity Module (MAM) of the National Energy Modeling System

    SciTech Connect

    Not Available

    1994-02-07

    This report documents the objectives, analytical approach, and development of the National Energy Modeling System (NEMS) Macroeconomic Activity Module (MAM) used to develop the Annual Energy Outlook for 1994 (AEO94). The report catalogues and describes the module assumptions, computations, methodology, parameter estimation techniques, and mainframe source code. This document serves three purposes. First, it is a reference document providing a detailed description of the NEMS MAM used for the AEO 1994 production runs for model analysts, users, and the public. Second, this report meets the legal requirement of the Energy Information Administration (EIA) to provide adequate documentation in support of its models (Public Law 94-385, section 57.b.2). Third, it facilitates continuity in model development by providing documentation from which energy analysts can undertake model enhancements, data updates, and parameter refinements as future projects.

  2. Determination of atmospheric moisture structure and infrared cooling rates from high resolution MAMS radiance data

    NASA Technical Reports Server (NTRS)

    Menzel, W. Paul; Moeller, Christopher C.; Smith, William L.

    1991-01-01

    This program has applied Multispectral Atmospheric Mapping Sensor (MAMS) high resolution data to the problem of monitoring atmospheric quantities of moisture and radiative flux at small spatial scales. MAMS, with 100-m horizontal resolution in its four infrared channels, was developed to study small scale atmospheric moisture and surface thermal variability, especially as related to the development of clouds, precipitation, and severe storms. High-resolution Interferometer Sounder (HIS) data has been used to develop a high spectral resolution retrieval algorithm for producing vertical profiles of atmospheric temperature and moisture. The results of this program are summarized and a list of publications resulting from this contract is presented. Selected publications are attached as an appendix.

  3. High resolution depiction of atmospheric moisture, stability and surface temperature from combined MAMS and VAS radiances

    NASA Technical Reports Server (NTRS)

    Moeller, C. C.; Strabala, K. I.; Menzel, W. P.

    1993-01-01

    In order to elucidate mesoscale variability of the earth-atmosphere system, aircraft-borne Multi-spectral Atmospheric Mapping Sensor (MAMS), 100-meter-resolution radiometric data, and geostationary-borne VISSR Atmospheric Sounder (VAS) 8-km-resolution radiometric data are used together in a physical retrieval method to produce 100-m-resolution depictions of atmospheric moisture, stability, and skin temperature. The VAS, with its IR-sounding capability, provides the vertical information to the retrieval while the MAMS, with its 100-m resolution, provides the horizontal information. The retrievals show mesoscale features, including a moist tongue intrusion and an urban heat island. Mesogamma-scale gradients are found to exceed mesobeta-scale gradients, and significant mesogamma-scale variability is not captured in current geostationary sounding data. It is suggested that improvements to the spatial resolution of operating sounding data will yield improved information on atmospheric and surface gradients, especially at the mesogamma scale.

  4. MamO Is a Repurposed Serine Protease that Promotes Magnetite Biomineralization through Direct Transition Metal Binding in Magnetotactic Bacteria

    PubMed Central

    Hershey, David M.; Ren, Xuefeng; Melnyk, Ryan A.; Browne, Patrick J.; Ozyamak, Ertan; Jones, Stephanie R.; Chang, Michelle C. Y.; Hurley, James H.; Komeili, Arash

    2016-01-01

    Many living organisms transform inorganic atoms into highly ordered crystalline materials. An elegant example of such biomineralization processes is the production of nano-scale magnetic crystals in magnetotactic bacteria. Previous studies implicated the involvement of two putative serine proteases, MamE and MamO, during the early stages of magnetite formation in Magnetospirillum magneticum AMB-1. Here, using genetic analysis and X-ray crystallography, we show that MamO has a degenerate active site, rendering it incapable of protease activity. Instead, MamO promotes magnetosome formation through two genetically distinct, noncatalytic activities: activation of MamE-dependent proteolysis of biomineralization factors and direct binding to transition metal ions. By solving the structure of the protease domain bound to a metal ion, we identify a surface-exposed di-histidine motif in MamO that contributes to metal binding and show that it is required to initiate biomineralization in vivo. Finally, we find that pseudoproteases are widespread in magnetotactic bacteria and that they have evolved independently in three separate taxa. Our results highlight the versatility of protein scaffolds in accommodating new biochemical activities and provide unprecedented insight into the earliest stages of biomineralization. PMID:26981620

  5. MamA as a Model Protein for Structure-Based Insight into the Evolutionary Origins of Magnetotactic Bacteria

    PubMed Central

    Lefèvre, Christopher T.; Arnoux, Pascal; Baran, Dror; Shtein, Zvi; Davidov, Geula; Zarivach, Raz

    2015-01-01

    MamA is a highly conserved protein found in magnetotactic bacteria (MTB), a diverse group of prokaryotes capable of navigating according to magnetic fields – an ability known as magnetotaxis. Questions surround the acquisition of this magnetic navigation ability; namely, whether it arose through horizontal or vertical gene transfer. Though its exact function is unknown, MamA surrounds the magnetosome, the magnetic organelle embedding a biomineralised nanoparticle and responsible for magnetotaxis. Several structures for MamA from a variety of species have been determined and show a high degree of structural similarity. By determining the structure of MamA from Desulfovibrio magneticus RS-1 using X-ray crystallography, we have opened up the structure-sequence landscape. As such, this allows us to perform structural- and phylogenetic-based analyses using a variety of previously determined MamA from a diverse range of MTB species across various phylogenetic groups. We found that MamA has remained remarkably constant throughout evolution with minimal change between different taxa despite sequence variations. These findings, coupled with the generation of phylogenetic trees using both amino acid sequences and 16S rRNA, indicate that magnetotaxis likely did not spread via horizontal gene transfer and instead has a significantly earlier, primordial origin. PMID:26114501

  6. MamO Is a Repurposed Serine Protease that Promotes Magnetite Biomineralization through Direct Transition Metal Binding in Magnetotactic Bacteria

    DOE PAGESBeta

    Hershey, David M.; Ren, Xuefeng; Melnyk, Ryan A.; Browne, Patrick J.; Ozyamak, Ertan; Jones, Stephanie R.; Chang, Michelle C. Y.; Hurley, James H.; Komeili, Arash

    2016-03-16

    Many living organisms transform inorganic atoms into highly ordered crystalline materials. An elegant example of such biomineralization processes is the production of nano-scale magnetic crystals in magnetotactic bacteria. Previous studies have implicated the involvement of two putative serine proteases, MamE and MamO, during the early stages of magnetite formation in Magnetospirillum magneticum AMB-1. Here, using genetic analysis and X-ray crystallography, we show that MamO has a degenerate active site, rendering it incapable of protease activity. Instead, MamO promotes magnetosome formation through two genetically distinct, noncatalytic activities: activation of MamE-dependent proteolysis of biomineralization factors and direct binding to transition metal ions.more » By solving the structure of the protease domain bound to a metal ion, we identify a surface-exposed di-histidine motif in MamO that contributes to metal binding and show that it is required to initiate biomineralization in vivo. Finally, we find that pseudoproteases are widespread in magnetotactic bacteria and that they have evolved independently in three separate taxa. In conclusion, our results highlight the versatility of protein scaffolds in accommodating new biochemical activities and provide unprecedented insight into the earliest stages of biomineralization.« less

  7. Alterations in spatial memory and anxiety in the MAM E17 rat model of hippocampal pathology in schizophrenia

    PubMed Central

    Gastambide, Francois; Taylor, Amy M; Palmer, Clare; Svard, Heta; Karjalainen, Maija; Janhunen, Sanna K; Tricklebank, Mark; Bannerman, David M

    2016-01-01

    Adult rats exposed to methylazoxymethanol acetate (MAM) at embryonic day 17 (E17) display robust pathological alterations in the hippocampus. However, discrepancies exist in the literature regarding the behavioural effects of this pre-natal manipulation. Therefore, a systematic assessment of MAM E17-induced behavioural alterations was conducted using a battery of dorsal and ventral hippocampus-dependent tests. Compared to saline controls, MAM E17-treated rats displayed deficits in spatial reference memory in both the aversive hidden platform watermaze task and an appetitive Y-maze task. Deficits in the spatial reference memory watermaze task were replicated across three different cohorts and two laboratories. In contrast, there was little, or no, effect on the non-spatial, visible platform watermaze task or an appetitive, non-spatial, visual discrimination task, respectively. MAM rats were also impaired in the spatial novelty preference task which assesses short-term memory, and displayed reduced anxiety levels in the elevated plus maze task. Thus, MAM E17 administration resulted in abnormal spatial information processing and reduced anxiety in a number of hippocampus-dependent behavioural tests, paralleling the effects of dorsal and ventral hippocampal lesions respectively. These findings corroborate recent pathological and physiological studies, further highlighting the usefulness of MAM E17 as a model of hippocampal dysfunction in at least some aspects of schizophrenia. PMID:25633092

  8. Alterations in spatial memory and anxiety in the MAM E17 rat model of hippocampal pathology in schizophrenia.

    PubMed

    Gastambide, Francois; Taylor, Amy M; Palmer, Clare; Svard, Heta; Karjalainen, Maija; Janhunen, Sanna K; Tricklebank, Mark; Bannerman, David M

    2015-11-01

    Adult rats exposed to methylazoxymethanol acetate (MAM) at embryonic day 17 (E17) display robust pathological alterations in the hippocampus. However, discrepancies exist in the literature regarding the behavioural effects of this pre-natal manipulation. Therefore, a systematic assessment of MAM E17-induced behavioural alterations was conducted using a battery of dorsal and ventral hippocampus-dependent tests. Compared to saline controls, MAM E17-treated rats displayed deficits in spatial reference memory in both the aversive hidden platform watermaze task and an appetitive Y-maze task. Deficits in the spatial reference memory watermaze task were replicated across three different cohorts and two laboratories. In contrast, there was little, or no, effect on the non-spatial, visible platform watermaze task or an appetitive, non-spatial, visual discrimination task, respectively. MAM rats were also impaired in the spatial novelty preference task which assesses short-term memory, and displayed reduced anxiety levels in the elevated plus maze task. Thus, MAM E17 administration resulted in abnormal spatial information processing and reduced anxiety in a number of hippocampus-dependent behavioural tests, paralleling the effects of dorsal and ventral hippocampal lesions, respectively. These findings corroborate recent pathological and physiological studies, further highlighting the usefulness of MAM E17 as a model of hippocampal dysfunction in at least some aspects of schizophrenia. PMID:25633092

  9. Inter-phylum structural conservation of the magnetosome-associated TPR-containing protein, MamA.

    PubMed

    Zeytuni, Natalie; Baran, Dror; Davidov, Geula; Zarivach, Raz

    2012-12-01

    Magnetotactic bacteria enclose the magnetosome, a unique prokaryotic sub-cellular organelle that allows the biomineralization of magnetic nano-crystals. Membrane-coated magnetosomes are arranged into a linear chain that permits magnetotactic bacteria to navigate geomagnetic fields. Magnetosome assembly and biomineralization are controlled by conserved magnetosome-associated proteins, including MamA, a tetra-trico-peptide repeat (TPR)-containing protein that was shown to coat the magnetosome membrane. In this study, two MamA structures from Candidatus Magnetobacterium bavaricum (Mbav) were determined via X-ray crystallography. These structures confirm that Mbav MamA folds as a sequential TPR protein and shares a high degree of structural similarity with homologous MamA proteins from Magnetospirillum species. Furthermore, the two TPR-containing domains of MamA are separated by an interphylum-conserved region containing a flexible hinge that is involved in ligand binding and recognition. Finally, substantial differences were found in the local stabilization of the MamA N-terminal domain as a result of the loss of an evolutionary conserved salt bridge. PMID:22917855

  10. Genetic Dissection of the mamAB and mms6 Operons Reveals a Gene Set Essential for Magnetosome Biogenesis in Magnetospirillum gryphiswaldense

    PubMed Central

    Lohße, Anna; Borg, Sarah; Raschdorf, Oliver; Kolinko, Isabel; Tompa, Éva; Pósfai, Mihály; Faivre, Damien; Baumgartner, Jens

    2014-01-01

    Biosynthesis of bacterial magnetosomes, which are intracellular membrane-enclosed, nanosized magnetic crystals, is controlled by a set of >30 specific genes. In Magnetospirillum gryphiswaldense, these are clustered mostly within a large conserved genomic magnetosome island (MAI) comprising the mms6, mamGFDC, mamAB, and mamXY operons. Here, we demonstrate that the five previously uncharacterized genes of the mms6 operon have crucial functions in the regulation of magnetosome biomineralization that partially overlap MamF and other proteins encoded by the adjacent mamGFDC operon. While all other deletions resulted in size reduction, elimination of either mms36 or mms48 caused the synthesis of magnetite crystals larger than those in the wild type (WT). Whereas the mms6 operon encodes accessory factors for crystal maturation, the large mamAB operon contains several essential and nonessential genes involved in various other steps of magnetosome biosynthesis, as shown by single deletions of all mamAB genes. While single deletions of mamL, -P, -Q, -R, -B, -S, -T, and -U showed phenotypes similar to those of their orthologs in a previous study in the related M. magneticum, we found mamI and mamN to be not required for at least rudimentary iron biomineralization in M. gryphiswaldense. Thus, only mamE, -L, -M, -O, -Q, and -B were essential for formation of magnetite, whereas a mamI mutant still biomineralized tiny particles which, however, consisted of the nonmagnetic iron oxide hematite, as shown by high-resolution transmission electron microscopy (HRTEM) and the X-ray absorption near-edge structure (XANES). Based on this and previous studies, we propose an extended model for magnetosome biosynthesis in M. gryphiswaldense. PMID:24816605

  11. 3-Methoxynaltrexone is not a selective antagonist for the acute psychomotor stimulating effects of heroin and 6-monoacetylmorphine in mice.

    PubMed

    Eriksen, Guro Søe; Andersen, Jannike Mørch; Boix, Fernando; Mørland, Jørg

    2014-07-01

    The opioid receptor antagonist 3-methoxynaltrexone (3-MeONtx) has previously been shown in rodents to selectively reverse the analgesic actions of heroin and its metabolites 6-monoacetylmorphine (6-MAM), and morphine-6-glucuronide (M6G), but not that of morphine. Based on these and other results, a heroin/6-MAM/M6G μ-opioid receptor binding site or subreceptor mediating their analgesic activity has been proposed. It is however unknown whether this also accounts for the acute psychomotor stimulating properties of these opioids. The aim of the present study was therefore to explore if the acute psychomotor stimulating effects of heroin, 6-MAM, and morphine are mediated by distinct μ-opioid receptor binding sites or subreceptors. To address this aim, we examined how pretreatment with 3-MeONtx or naltrexone (NTX) affected the acute increase in locomotor activity induced by heroin, 6-MAM, or morphine in mice. The pharmacokinetic profiles of 3-MeONtx and NTX were also assessed in mouse brain. We found that 3-MeONtx similarly antagonized the acute increase in locomotor activity induced by equipotent doses of heroin, 6-MAM, or morphine. This antagonistic effect was comparable to the one observed following administration of NTX, and both antagonists gave similar pharmacokinetic profiles in mouse brain. Our findings do not support that different μ-opioid receptor subtypes or a distinct binding site at the μ-opioid receptor is involved in morphine-induced versus heroin/6-MAM-induced psychomotor activation. This might suggest that the opioid-induced psychomotor stimulation is mediated by different μ-opioid subreceptors than those responsible for their analgesic effects. PMID:24699386

  12. Size control of in vitro synthesized magnetite crystals by the MamC protein of Magnetococcus marinus strain MC-1.

    PubMed

    Valverde-Tercedor, C; Montalbán-López, M; Perez-Gonzalez, T; Sanchez-Quesada, M S; Prozorov, T; Pineda-Molina, E; Fernandez-Vivas, M A; Rodriguez-Navarro, A B; Trubitsyn, D; Bazylinski, Dennis A; Jimenez-Lopez, C

    2015-06-01

    Magnetotactic bacteria are a diverse group of prokaryotes that share the unique ability of biomineralizing magnetosomes, which are intracellular, membrane-bounded crystals of either magnetite (Fe3O4) or greigite (Fe3S4). Magnetosome biomineralization is mediated by a number of specific proteins, many of which are localized in the magnetosome membrane, and thus is under strict genetic control. Several studies have partially elucidated the effects of a number of these magnetosome-associated proteins in the control of the size of magnetosome magnetite crystals. However, the effect of MamC, one of the most abundant proteins in the magnetosome membrane, remains unclear. In this present study, magnetite nanoparticles were synthesized inorganically in free-drift experiments at 25 °C in the presence of different concentrations of the iron-binding recombinant proteins MamC and MamCnts (MamC without its first transmembrane segment) from the marine, magnetotactic bacterium Magnetococcus marinus strain MC-1 and three commercial proteins [α-lactalbumin (α-Lac), myoglobin (Myo), and lysozyme (Lyz)]. While no effect was observed on the size of magnetite crystals formed in the presence of the commercial proteins, biomimetic synthesis in the presence of MamC and MamCnts at concentrations of 10-60 μg/mL resulted in the production of larger and more well-developed magnetite crystals (~30-40 nm) compared to those of the control (~20-30 nm; magnetite crystals grown protein-free). Our results demonstrate that MamC plays an important role in the control of the size of magnetite crystals and could be utilized in biomimetic synthesis of magnetite nanocrystals. PMID:25874532

  13. Food Price Spikes Are Associated with Increased Malnutrition among Children in Andhra Pradesh, India123

    PubMed Central

    Vellakkal, Sukumar; Fledderjohann, Jasmine; Basu, Sanjay; Agrawal, Sutapa; Ebrahim, Shah; Campbell, Oona; Doyle, Pat; Stuckler, David

    2015-01-01

    Background: Global food prices have risen sharply since 2007. The impact of food price spikes on the risk of malnutrition in children is not well understood. Objective: We investigated the associations between food price spikes and childhood malnutrition in Andhra Pradesh, one of India’s largest states, with >85 million people. Because wasting (thinness) indicates in most cases a recent and severe process of weight loss that is often associated with acute food shortage, we tested the hypothesis that the escalating prices of rice, legumes, eggs, and other staples of Indian diets significantly increased the risk of wasting (weight-for-height z scores) in children. Methods: We studied periods before (2006) and directly after (2009) India’s food price spikes with the use of the Young Lives longitudinal cohort of 1918 children in Andhra Pradesh linked to food price data from the National Sample Survey Office. Two-stage least squares instrumental variable models assessed the relation of food price changes to food consumption and wasting prevalence (weight-for-height z scores). Results: Before the 2007 food price spike, wasting prevalence fell from 19.4% in 2002 to 18.8% in 2006. Coinciding with India’s escalating food prices, wasting increased significantly to 28.0% in 2009. These increases were concentrated among low- (χ2: 21.6, P < 0.001) and middle- (χ2: 25.9, P < 0.001) income groups, but not among high-income groups (χ2: 3.08, P = 0.079). Each 10.0 rupee ($0.170) increase in the price of rice/kg was associated with a drop in child-level rice consumption of 73.0 g/d (β: −7.30; 95% CI: −10.5, −3.90). Correspondingly, lower rice consumption was significantly associated with lower weight-for-height z scores (i.e., wasting) by 0.005 (95% CI: 0.001, 0.008), as seen with most other food categories. Conclusion: Rising food prices were associated with an increased risk of malnutrition among children in India. Policies to help ensure the affordability of food

  14. Malnutrition and Dehydration in the Third World: Practical Treatment

    PubMed Central

    Cowtan, Edgar R.

    1985-01-01

    Malnutrition coupled with dehydration (usually secondary to diarrhea) is one of the major causes of morbidity and death in the Third World. The mortality rate is high, especially in children; four to five million die each year. However, diagnosis and treatment of these problems has improved in the past decade. In therapeutic feeding programs, which are designed for markedly malnourished children, oral rehydration solution is likely the most important medicine that can be offered. After initial rehydration, the malnutrition can be treated with six to nine meals daily, and/or nasal-gastric feeding and special high energy milk formulas. Patients usually require four to six weeks before moving to a supplementary program, which supplies an additional 350-500 kilocalories and an extra 15 g of protein to the daily diet. This program is for those at high risk: children under age five, pregnant and lactating women, and certain debilitated patients. ImagesFig. 1 PMID:21274127

  15. Zellweger syndrome with severe malnutrition, immunocompromised state and opportunistic infections.

    PubMed

    Cardoso, Patrícia; Amaral, Maria Emanuel; Lemos, Sónia; Garcia, Paula

    2016-01-01

    Peroxisome biogenesis disorders are related to a spectrum of genetic diseases that range from severe Zellweger syndrome to milder infantile Refsum disease. Zellweger syndrome is characterised by dysmorphic features, severe hypotonia, seizures, failure to thrive, liver dysfunction and skeletal defects. Increased levels of very long chain fatty acids are the biochemical hallmark and the most common mutations found in the PEX1 gene. We report an unusual presentation of Zellweger syndrome in a 2-month-old female infant with severe malnutrition, opportunistic infections, lymphopaenia and a small thymic shadow on chest radiography. With this clinical picture, an initial hypothesis of primary immunodeficiency was considered. It was later confirmed to not be the case. On follow-up, global developmental delay, bilateral optic nerve atrophy and moderate bilateral sensorineural deafness grade II were documented. There were no further infectious complications and we concluded malnutrition was the cause of the infant's immunocompromised state. PMID:27090541

  16. Malnutrition in spinal cord injury: more than nutritional deficiency.

    PubMed

    Dionyssiotis, Yannis

    2012-08-01

    Denervation of the spinal cord below the level of injury leads to complications producing malnutrition. Nutritional status affects mortality and pathology of injured subjects and it has been reported that two thirds of individuals enrolled in rehabilitation units are malnourished. Therefore, the aim should be either to maintain an optimal nutritional status, or supplement these subjects in order to overcome deficiencies in nutrients or prevent obesity. This paper reviews methods of nutritional assessment and describes the physiopathological mechanisms of malnutrition based on the assumption that spinal cord injured subjects need to receive adequate nutrition to promote optimal recovery, placing nutrition as a first line treatment and not an afterthought in the rehabilitation of spinal cord injury. PMID:22870169

  17. Vegetation change, malnutrition and violence in the Horn of Africa

    NASA Astrophysics Data System (ADS)

    Rowhani, P.; Degomme, O.; Linderman, M.; Guha-Sapir, D.; Lambin, E.

    2008-12-01

    In certain circumstances, climate change in association with a broad range of social factors may increase the risk of famines and subsequently, violent conflict. The impacts of climate change on society will be experienced both through changes in mean conditions over long time periods and through increases in extreme events. Recent studies have shown the historical effects of long term climate change on societies and the importance of short term climatic triggers on armed conflict. However, most of these studies are at the state level ignoring local conditions. Here we use detailed information extracted from wide-swath satellite data (MODIS) to analyze the impact of climate variability change on malnutrition and violent conflict. More specifically, we perform multivariate logistic regression analysis in order to explain the geographical distribution of malnutrition and conflict in the Horn of Africa on a sub-national level. This region, constituted by several unstable and poor states, has been affected by droughts, floods, famines, and violence in the past few years. Three commonly used nutrition and mortality indicators are used to characterize the health situation (CE-DAT database). To map violence we use the georeferenced Armed Conflicts dataset developed by the Center for the Study of Civil War. Explanatory variables include several socio-economic variables and environmental variables characterizing land degradation, vegetation activity, and interannual variability in land-surface conditions. First results show that interannual variability in land-surface conditions is associated with malnutrition but not with armed conflict. Furthermore, land degradation seems not to be associated with either malnutrition or armed conflict.

  18. ADDUCTOR POLLICIS MUSCLE AS PREDICTOR OF MALNUTRITION IN SURGICAL PATIENTS

    PubMed Central

    de MELO, Camila Yandara Sousa Vieira; da SILVA, Silvia Alves

    2014-01-01

    Background In the compromised nutritional status, there is excessive skeletal muscle loss and decreased inflammatory response, contributing to increased morbidity and mortality and length of stay. Aim To estimate the prevalence of malnutrition by measuring adductor pollicis muscle using cutoffs for surgical patients suggested in the literature. Methods Cross-sectional study with 151 patients scheduled for elective surgical procedure. Nutritional assessment was performed by classical anthropometric measurements: arm circumference, triceps skinfold thickness, arm muscle circumference, corrected arm muscle area, BMI and percentage of weight loss and the extent of the adductor pollicis muscle in both hands. Results The prevalence of malnutrition in patients was high. A significant association between nutritional diagnosis according to the measures of adductor pollicis muscle and arm circumference, BMI and triceps skinfold thickness but there was no association with arm muscular circumference, arm muscular area or percentage of weight loss. Conclusion The adductor pollicis muscle has proved to be a good method to diagnose muscle depletion and malnutrition in surgical patients. PMID:24676291

  19. In vitro assembly of the bacterial actin protein MamK from ' Candidatus Magnetobacterium casensis' in the phylum Nitrospirae.

    PubMed

    Deng, Aihua; Lin, Wei; Shi, Nana; Wu, Jie; Sun, Zhaopeng; Sun, Qinyun; Bai, Hua; Pan, Yongxin; Wen, Tingyi

    2016-04-01

    Magnetotactic bacteria (MTB), a group of phylogenetically diverse organisms that use their unique intracellular magnetosome organelles to swim along the Earth's magnetic field, play important roles in the biogeochemical cycles of iron and sulfur. Previous studies have revealed that the bacterial actin protein MamK plays essential roles in the linear arrangement of magnetosomes in MTB cells belonging to the Proteobacteria phylum. However, the molecular mechanisms of multiple-magnetosome-chain arrangements in MTB remain largely unknown. Here, we report that the MamK filaments from the uncultivated 'Candidatus Magnetobacterium casensis' (Mcas) within the phylum Nitrospirae polymerized in the presence of ATP alone and were stable without obvious ATP hydrolysis-mediated disassembly. MamK in Mcas can convert NTP to NDP and NDP to NMP, showing the highest preference to ATP. Unlike its Magnetospirillum counterparts, which form a single magnetosome chain, or other bacterial actins such as MreB and ParM, the polymerized MamK from Mcas is independent of metal ions and nucleotides except for ATP, and is assembled into well-ordered filamentous bundles consisted of multiple filaments. Our results suggest a dynamically stable assembly of MamK from the uncultivated Nitrospirae MTB that synthesizes multiple magnetosome chains per cell. These findings further improve the current knowledge of biomineralization and organelle biogenesis in prokaryotic systems. PMID:26960409

  20. Neuropathological and Reelin Deficiencies in the Hippocampal Formation of Rats Exposed to MAM; Differences and Similarities with Schizophrenia

    PubMed Central

    Frieling, Helge; Kebir, Oussama; Le Pen, Gwenaëlle; Beuvon, Frédéric; Daumas-Duport, Catherine; Jay, Thérèse M.; Krebs, Marie-Odile

    2010-01-01

    Background Adult rats exposed to methylazoxymethanol (MAM) at embryonic day 17 (E17) consistently display behavioral characteristics similar to that observed in patients with schizophrenia and replicate neuropathological findings from the prefrontal cortex of psychotic individuals. However, a systematic neuropathological analysis of the hippocampal formation and the thalamus in these rats is lacking. It is also unclear if reelin, a protein consistently associated with schizophrenia and potentially involved in the mechanism of action of MAM, participates in the neuropathological effects of this compound. Therefore, a thorough assessment including cytoarchitectural and neuromorphometric measurements of eleven brain regions was conducted. Numbers of reelin positive cells and reelin expression and methylation levels were also studied. Principal Findings Compared to untreated rats, MAM-exposed animals showed a reduction in the volume of entorhinal cortex, hippocampus and mediodorsal thalamus associated with decreased neuronal soma. The entorhinal cortex also showed laminar disorganization and neuronal clusters. Reelin methylation in the hippocampus was decreased whereas reelin positive neurons and reelin expression were unchanged. Conclusions Our results indicate that E17-MAM exposure reproduces findings from the hippocampal formation and the mediodorsal thalamus of patients with schizophrenia while providing little support for reelin's involvement. Moreover, these results strongly suggest MAM-treated animals have a diminished neuropil, which likely arises from abnormal neurite formation; this supports a recently proposed pathophysiological hypothesis for schizophrenia. PMID:20421980

  1. Association between blood cadmium levels and malnutrition in peritoneal dialysis

    PubMed Central

    2014-01-01

    Background Malnutrition is associated with an increased risk of cardiovascular death and may cause protein-energy wasting in individuals with chronic kidney disease. A previous study demonstrated that blood cadmium levels (BCLs) were associated with malnutrition in maintenance hemodialysis (MHD) patients. However, the correlation between cadmium exposure and malnutrition remains unclear in chronic peritoneal dialysis (CPD) patients. This study examined the possible adverse effects of environmental cadmium exposure in CPD patients. Methods A total of 301 CPD patients were enrolled and divided into 3 study groups based on the following BCL tertiles: low (<0.19 μg/L), middle (0.19–0.39 μg/L), and high (>0.39 μg/L). Demographic, hematological, biochemical, and dialysis-related data were obtained for analysis. The analysis also included values of nutritional and inflammatory markers. Results The BCLs of CPD patients were lower than those of MHD patients. At baseline, patients in the high BCL group were older and had a higher prevalence of diabetes mellitus but lower serum albumin, creatinine, and phosphate levels than the patients in the other 2 groups. After adjusting for potential variables, stepwise backward multiple linear regression analysis revealed that age and alanine aminotransferase levels were positively associated with logarithmic transformation of BCLs (log BCLs), while serum albumin levels were negatively associated with log BCLs in CPD patients. The log BCLs were a significant determinant (beta coefficient ± standard error = -0.185 ± 0.074; P = 0.013) of nutritional status and significantly associated with the presence of malnutrition (odds ratio = 2.64; 95% confidence interval: 1.07–6.48; P = 0.035) in CPD patients after adjustment for related variables. Conclusions BCL is significantly associated with nutritional status and malnutrition in CPD patients. Therefore, it is important for CPD patients to avoid

  2. The MAMS Quick View System-2 (QVS2) - A workstation for NASA aircraft scanner data evaluation

    NASA Technical Reports Server (NTRS)

    Jedlovec, Gary J.; James, Mark W.; Smith, Matthew R.; Atkinson, Robert J.

    1991-01-01

    This paper describes a ground-based data-evaluation workstation named Quick View System-2 (QVS2) developed to support postflight evaluation of data supplied by the Multispectral Atmospheric Mapping Sensor (MAMS), one of the four spectrometers that can be used with the Daedalus scanner flown on the ER-2 aircraft. The QVS2 provides advanced analysis capabilities and can be applied to other airborne scanners used throughout NASA for earth-system-science investigations, because of the commonality in the data stream and in the generalized data structure.

  3. Malnutrition and gastrointestinal and respiratory infections in children: a public health problem.

    PubMed

    Rodríguez, Leonor; Cervantes, Elsa; Ortiz, Rocío

    2011-04-01

    Infectious disease is the major cause of morbidity and mortality in developing countries, particularly in children. Increasing evidence suggests that protein-calorie malnutrition is the underlying reason for the increased susceptibility to infections observed in these areas. Moreover, certain infectious diseases also cause malnutrition, which can result in a vicious cycle. Malnutrition and bacterial gastrointestinal and respiratory infections represent a serious public health problem. The increased incidence and severity of infections in malnourished children is largely due to the deterioration of immune function; limited production and/or diminished functional capacity of all cellular components of the immune system have been reported in malnutrition. In this review, we analyze the cyclical relationship between malnutrition, immune response dysfunction, increased susceptibility to infectious disease, and metabolic responses that further alter nutritional status. The consequences of malnutrition are diverse and included: increased susceptibility to infection, impaired child development, increased mortality rate and individuals who come to function in suboptimal ways. PMID:21695035

  4. Malnutrition and Gastrointestinal and Respiratory Infections in Children: A Public Health Problem

    PubMed Central

    Rodríguez, Leonor; Cervantes, Elsa; Ortiz, Rocío

    2011-01-01

    Infectious disease is the major cause of morbidity and mortality in developing countries, particularly in children. Increasing evidence suggests that protein-calorie malnutrition is the underlying reason for the increased susceptibility to infections observed in these areas. Moreover, certain infectious diseases also cause malnutrition, which can result in a vicious cycle. Malnutrition and bacterial gastrointestinal and respiratory infections represent a serious public health problem. The increased incidence and severity of infections in malnourished children is largely due to the deterioration of immune function; limited production and/or diminished functional capacity of all cellular components of the immune system have been reported in malnutrition. In this review, we analyze the cyclical relationship between malnutrition, immune response dysfunction, increased susceptibility to infectious disease, and metabolic responses that further alter nutritional status. The consequences of malnutrition are diverse and included: increased susceptibility to infection, impaired child development, increased mortality rate and individuals who come to function in suboptimal ways. PMID:21695035

  5. Factors associated with malnutrition among tribal children in India: a non-parametric approach.

    PubMed

    Debnath, Avijit; Bhattacharjee, Nairita

    2014-06-01

    The purpose of this study is to identify the determinants of malnutrition among the tribal children in India. The investigation is based on secondary data compiled from the National Family Health Survey-3. We used a classification and regression tree model, a non-parametric approach, to address the objective. Our analysis shows that breastfeeding practice, economic status, antenatal care of mother and women's decision-making autonomy are negatively associated with malnutrition among tribal children. We identify maternal malnutrition and urban concentration of household as the two risk factors for child malnutrition. The identified associated factors may be used for designing and targeting preventive programmes for malnourished tribal children. PMID:24415743

  6. Insight into the Evolution of Magnetotaxis in Magnetospirillum spp., Based on mam Gene Phylogeny

    PubMed Central

    Lefèvre, Christopher T.; Schmidt, Marian L.; Viloria, Nathan; Trubitsyn, Denis; Schüler, Dirk

    2012-01-01

    Vibrioid- to helical-shaped magnetotactic bacteria phylogenetically related to the genus Magnetospirillum were isolated in axenic cultures from a number of freshwater and brackish environments located in the southwestern United States. Based on 16S rRNA gene sequences, most of the new isolates represent new Magnetospirillum species or new strains of known Magnetospirillum species, while one isolate appears to represent a new genus basal to Magnetospirillum. Partial sequences of conserved mam genes, genes reported to be involved in the magnetosome and magnetosome chain formation, and form II of the ribulose-1,5-bisphosphate carboxylase/oxygenase gene (cbbM) were determined in the new isolates and compared. The cbbM gene was chosen for comparison because it is not involved in magnetosome synthesis; it is highly conserved and is present in all but possibly one of the genomes of the magnetospirilla and the new isolates. Phylogenies based on 16S rRNA, cbbM, and mam gene sequences were reasonably congruent, indicating that the genes involved in magnetotaxis were acquired by a common ancestor of the Magnetospirillum clade. However, in one case, magnetosome genes might have been acquired through horizontal gene transfer. Our results also extend the known diversity of the Magnetospirillum group and show that they are widespread in freshwater environments. PMID:22865076

  7. Socio-cultural determinants of infant malnutrition in Cameroon.

    PubMed

    Pemunta, Ngambouk Vitalis; Fubah, Mathias Alubafi

    2015-07-01

    This study seeks to explore and explain the socio-cultural factors responsible for the incidence of infant malnutrition in Cameroon with particular emphasis on northern Cameroon where it is most accentuated. It combines quantitative data drawn from the 1991, 1998, 2004 and 2011 Cameroon Demographic and Health Surveys, as well as a literature review of publications by the WHO and UNICEF. This is further complemented with qualitative data from various regions of Cameroon, partly from a national ethnographic study on the ethno-medical causes of infertility in Cameroon conducted between 1999 and 2000. Whereas socio-cultural factors related to child feeding and maternal health (breast-feeding, food taboos and representations of the colostrum as dangerous for infants) are widespread throughout Cameroon, poverty-related factors (lack of education for mothers, natural disaster, unprecedented influx of refugees, inaccessibility and inequity in the distribution of health care services) are pervasive in northern Cameroon. This conjunction of factors accounts for the higher incidence of infant malnutrition and mortality in northern Cameroon. The study suggests the need for women's empowerment and for health care personnel in transcultural situations to understand local cultural beliefs, practices and sentiments before initiating change efforts in infant feeding practices and maternal health. Biomedical services should be tailored to the social and cultural needs of the target population--particularly women--since beliefs and practices underpin therapeutic recourse. Whereas infant diarrhoea might be believed to be the result of sexual contact, in reality, it is caused by unhygienic conditions. Similarly, weaning foods aimed at transmitting ethnic identity might not meet a child's age-specific food needs and might instead give rise to malnutrition. PMID:24717356

  8. MAM-2201, a synthetic cannabinoid drug of abuse, suppresses the synaptic input to cerebellar Purkinje cells via activation of presynaptic CB1 receptors.

    PubMed

    Irie, Tomohiko; Kikura-Hanajiri, Ruri; Usami, Makoto; Uchiyama, Nahoko; Goda, Yukihiro; Sekino, Yuko

    2015-08-01

    Herbal products containing synthetic cannabinoids-initially sold as legal alternatives to marijuana-have become major drugs of abuse. Among the synthetic cannabinoids, [1-(5-fluoropentyl)-1H-indol-3-yl](4-methyl-1-naphthalenyl)-methanone (MAM-2201) has been recently detected in herbal products and has psychoactive and intoxicating effects in humans, suggesting that MAM-2201 alters brain function. Nevertheless, the pharmacological actions of MAM-2201 on cannabinoid receptor type 1 (CB1R) and neuronal functions have not been elucidated. We found that MAM-2201 acted as an agonist of human CB1Rs expressed in AtT-20 cells. In whole-cell patch-clamp recordings made from Purkinje cells (PCs) in slice preparations of the mouse cerebellum, we also found that MAM-2201 inhibited glutamate release at parallel fiber-PC synapses via activation of presynaptic CB1Rs. MAM-2201 inhibited neurotransmitter release with an inhibitory concentration 50% of 0.36 μM. MAM-2201 caused greater inhibition of neurotransmitter release than Δ(9)-tetrahydrocannabinol within the range of 0.1-30 μM and JWH-018, one of the most popular and potent synthetic cannabinoids detected in the herbal products, within the range of 0.03-3 μM. MAM-2201 caused a concentration-dependent suppression of GABA release onto PCs. Furthermore, MAM-2201 induced suppression of glutamate release at climbing fiber-PC synapses, leading to reduced dendritic Ca(2+) transients in PCs. These results suggest that MAM-2201 is likely to suppress neurotransmitter release at CB1R-expressing synapses in humans. The reduction of neurotransmitter release from CB1R-containing synapses could contribute to some of the symptoms of synthetic cannabinoid intoxication including impairments in cerebellum-dependent motor coordination and motor learning. PMID:25747605

  9. Chronic malnutrition among overweight Hispanic children: understanding health disparities.

    PubMed

    Iriart, Celia; Handal, Alexis J; Boursaw, Blake; Rodrigues, Gabriela

    2011-12-01

    Obesity may be masking other health problems such as height deficit, or stunting. Stunting may reflect the cumulative effect of chronic malnutrition especially in underserved immigrant communities. Exploratory analysis of a sample of children 2-19 years old from the 2007-2008 NHANES was used to assess the relationship between chronic malnutrition and overweight/obesity in Hispanic children. Overall, overweight/obesity prevalence was nearly 1 in 3 children and stunting prevalence was 3.1%. The prevalence of stunting varied significantly across race/ethnicity, with prevalence among Hispanics of 6.6%. Prevalence of stunting varied significantly by socio-economic characteristics within the Hispanic population. Our exploratory study showed differences in the prevalence of stunting across racial/ethnic groups and highlighted that overweight/obese Hispanic children have a higher prevalence of stunting compared with Non-Hispanic White overweight/obese children. More studies are needed to better understand the phenomenon and the implications for health inequities. PMID:21416269

  10. Malnutrition in Sub-Saharan Africa: burden, causes and prospects.

    PubMed

    Bain, Luchuo Engelbert; Awah, Paschal Kum; Geraldine, Ngia; Kindong, Njem Peter; Sigal, Yelena; Bernard, Nsah; Tanjeko, Ajime Tom

    2013-01-01

    Malnutrition is estimated to contribute to more than one third of all child deaths, although it is rarely listed as the direct cause. Contributing to more than half of deaths in children worldwide; child malnutrition was associated with 54% of deaths in children in developing countries in 2001. Poverty remains the major contributor to this ill. The vicious cycle of poverty, disease and illness aggravates this situation. Grooming undernourished children causes children to start life at mentally sub optimal levels. This becomes a serious developmental threat. Lack of education especially amongst women disadvantages children, especially as far as healthy practices like breastfeeding and child healthy foods are concerned. Adverse climatic conditions have also played significant roles like droughts, poor soils and deforestation. Sociocultural barriers are major hindrances in some communities, with female children usually being the most affected. Corruption and lack of government interest and investment are key players that must be addressed to solve this problem. A multisectorial approach is vital in tackling this problem. Improvement in government policy, fight against corruption, adopting a horizontal approach in implementing programmes at community level must be recognized. Genetically modified foods to increase food production and to survive adverse climatic conditions could be gateways in solving these problems. Socio cultural peculiarities of each community are an essential base line consideration for the implementation of any nutrition health promotion programs. PMID:24255726

  11. Protein-energy malnutrition: a risk factor for various ailments.

    PubMed

    Batool, Rizwana; Butt, Masood Sadiq; Sultan, Muhammad Tauseef; Saeed, Farhan; Naz, Rabia

    2015-01-01

    The wheel of industrialization that spun throughout the last century resulted in urbanization coupled with modifications in lifestyles and dietary habits. However, the communities living in developing economies are facing many problems related to their diet and health. Amongst, the prevalence of nutritional problems especially protein-energy malnutrition (PEM) and micronutrients deficiencies are the rising issues. Moreover, the immunity or susceptibility to infect-parasitic diseases is also directly linked with the nutritional status of the host. Likewise, disease-related malnutrition that includes an inflammatory component is commonly observed in clinical practice thus affecting the quality of life. The PEM is treatable but early detection is a key for its appropriate management. However, controlling the menace of PEM requires an aggressive partnership between the physician and the dietitian. This review mainly attempts to describe the pathophysiology, prevalence and consequences of PEM and aims to highlight the importance of this clinical syndrome and the recent growth in our understanding of the processes behind its development. Some management strategies/remedies to overcome PEM are also the limelight of the article. In the nutshell, early recognition, prompt management, and robust follow up are critical for best outcomes in preventing and treating PEM. PMID:24915388

  12. Protein-energy malnutrition and anemia in Kivu.

    PubMed

    Fondu, P; Hariga-Muller, C; Mozes, N; Neve, J; Van Steirteghem, A; Mandelbaum, I M

    1978-01-01

    Protein-energy malnutrition in Kivu is associated with a discrete normocytic, normochromic anemia. An attempt to define the physiopathology of this anemia disclosed the following results. As compared with local controls, both iron and total iron binding capacity were low, but with siderophilin saturation and sideroblast counts either normal or elevated; serum and erythrocyte folate was normal, plasma vitamin B12 was normal or elevated, and serum ascorbic acid was normal or elevated. The riboflavin nutritional status was normal. During refeeding, iron and riboflavin deficiencies became apparent. Characteristic findings on admission were the presence of giant erythroblasts and a diminished erythrocyte survival time implicated to an intracorpuscular hemolysis. Two results from the present study could contribute to explanation for the aforementioned abnormalities: low plasma vitamin E levels and, perhaps more importantly, low plasma selenium levels. In conclusion, the anemia of protein-energy malnutrition, as observed in Kivu, is a classifiable nonadaptive anemia that cannot be explained by isolated iron or vitamin deficiencies and whose physiopathology is distinct from that of the anemia of chronic disorders. It is suggested that a selenium deficiency may play an important role in the pathogenesis of this anemia. PMID:413429

  13. Malnutrition Markers and Serum Ghrelin Levels in Hemodialysis Patients

    PubMed Central

    Montazerifar, Farzaneh; Karajibani, Mansour; Gorgij, Farnia; Akbari, Ommolbanin

    2014-01-01

    Objective. The aim of study was to investigate the changes levels of serum ghrelin in HD patients and its relationship to some malnutrition markers compared with healthy controls. Methods. Forty-five patients on hemodialysis and forty healthy controls were studied. Biochemical parameters and serum ghrelin levels were measured. Both daily dietary intakes and body mass index (BMI) assessments were performed for evaluation of nutritional status. Results. Ghrelin concentrations were significantly reduced in patients undergoing hemodialysis when compared to healthy controls (5 ± 0.68 (1.1–18.5) pg/mL versus 7.8 ± 0.84 (2.4–18.3) pg/mL; P = 0.004). BMI and serum albumin in HD patients were markedly reduced compared to controls. The patients with an insufficient intake of energy and protein demonstrated slightly lower levels of serum ghrelin. A negative correlation between serum ghrelin concentration with age (r = −0.34, P = 0.02), BUN (r = −0.26, P < 0.01), and serum creatinine (r = −0.27, P < 0.01) was observed in HD patients. Conclusions. The findings suggest that decreased ghrelin levels in HD patients might be associated with anorexia. Further studies are needed to determine changes in serum ghrelin levels during dialysis and to clarify whether the decrease in ghrelin levels contributes to the malnutrition that is common in these patients.

  14. Severe steatohepatitis with hepatic decompensation resulting from malnutrition after pancreaticoduodenectomy

    PubMed Central

    Sim, Eun Hui; Kim, Se Young; Jung, Seung Min; Maeng, Lee-So; Jang, Jeong Won; Chung, Kyu Won

    2012-01-01

    The most common finding related to nonalcoholic steatohepatitis is obesity, but a status of severe malnutrition can also induce the steatohepatitis. The authors report a rare case of steatohepatitis leading to hepatic decompensation caused by malnutrition after pancreaticoduodenectomy. A 68-year-old female patient who had been previously diagnosed with pancreatic cancer and had undergone pancreaticoduodenectomy 5 months previously presented with abdominal distension. Routine CT performed 3 months after the surgery revealed severe fatty liver without evidence of tumor recurrence. After undergoing pancreaticoduodenectomy her food intake had reduced, and as a result she had lost 7 kg of body weight over 2 months. At this admission, CT revealed moderate amounts of ascites without tumor recurrence. Furthermore, her albumin and lipid profile levels were markedly decreased, and she had a flapping tremor and slurred speech suggestive of hepatic encephalopathy. Her liver biopsy findings were consistent with steatohepatitis and disclosed macrovesicular steatosis without definite fibrosis. After careful nutritional control, her symptoms disappeared and her laboratory findings improved. PMID:23323257

  15. Testing Orofacial Abilities of Children Who Stutter: The Movement, Articulation, Mandibular and Sensory Awareness (MAMS) Assessment Procedure

    ERIC Educational Resources Information Center

    Cook, Susanne; Rieger, Martina; Donlan, Chris; Howell, Peter

    2011-01-01

    Objective: The purpose of this article is to introduce a new assessment designed to measure the orofacial abilities of children who stutter (CWS), the Movement, Articulation, Mandibular and Sensory Awareness (MAMS) Orofacial Assessment. The new instrument was developed and validated to measure orofacial abilities in a comprehensive manner. Design:…

  16. Diagnostics of Western Himalayan Satluj River flow: Warm season (MAM/JJAS) inflow into Bhakra dam in India

    NASA Astrophysics Data System (ADS)

    Pal, Indrani; Lall, Upmanu; Robertson, Andrew W.; Cane, Mark A.; Bansal, Rajeev

    2013-01-01

    SummaryHere we analyze the variability of MAM (March-April-May) and JJAS (June-July-August-September) seasonal Satluj River flow into the Bhakra dam in India through Pearson anomaly correlation and composite analyses with antecedent and concurrent seasonal climatic and atmospheric circulation patterns. The MAM seasonal inflow of Bhakra dam is significantly correlated with winter (DJF/FM) precipitation and temperature of the Satluj basin while the correlation with FM was more prominent for precipitation (snow = +0.72, rainfall = +0.60), and temperature (diurnal temperature range (DTR) = -0.76 and maximum temperature (Tmax) = -0.57). The JJAS inflow was also positively correlated with DJF/FM as well as JJAS precipitation of the Satluj basin while the correlation with basin average FM was the largest (+0.54). These suggested that both MAM and JJAS inflow anomalies are linked with DJF/FM climate over the Western Himalayas and adjoining north and central Indian plains, which were also found to be linked with the fluctuation of equatorial concurrent Sea Surface Temperature anomalies over the western Indian Ocean (max anomaly correlation was > +0.70) and mean sea level pressure over western pole of the Southern Oscillation sea-saw region (max Pearson anomaly correlation was ˜ +0.60). Low (high) MAM inflow was found to be associated with negative (positive) precipitation anomalies over the basin and north India in DJF and FM while FM precipitation anomaly is more concentrated over the Western Himalayas. In addition, low (high) JJAS inflow is also associated with negative (positive) precipitation anomalies over the basin and north India in DJF and over the Western Himalaya in FM and JJAS. Negative geopotential height anomaly at 500 h Pa (Z500) over Siberia and northwestern pacific in DJF, and positive Z500 anomaly over the northwest India in FM were noticed in low MAM inflow years. Whereas high inflow in MAM was linked with a negative Z500 anomaly between two positive Z500

  17. Malnutrition as an enteric infectious disease with long-term effects on child development

    PubMed Central

    Guerrant, Richard L; Oriá, Reinaldo B; Moore, Sean R; Oriá, Mônica OB; Lima, Aldo AM

    2008-01-01

    Malnutrition is a major contributor to mortality and is increasingly recognized as a cause of, potentially lifelong, functional disability. Yet, a rate-limiting step in achieving normal nutrition may be impaired absorptive function due to multiple repeated enteric infections. This is especially problematic in children whose diets are marginal. In malnourished individuals, the infections are even more devastating. This review documents the evidence that intestinal infections lead to malnutrition and that malnutrition worsens intestinal infections. The clinical data presented here derive largely from long-term cohort studies that are supported by controlled animal studies. Also reviewed are the mechanisms by which enteric infections lead to undernutrition and by which malnutrition worsens enteric infections, with implications for potential novel interventions. Further intervention studies are needed to document the relevance of these mechanisms and, most importantly, to interrupt the vicious diarrhea-malnutrition cycle so children may develop their full potential. PMID:18752473

  18. High oleic ready-to-use therapeutic food maintains docosahexaenoic acid status in severe malnutrition: a randomized, blinded trial

    PubMed Central

    Hsieh, Ji-Cheng; Liu, Lei; Zeilani, Mamane; Ickes, Scott; Trehan, Indi; Maleta, Ken; Craig, Christina; Thakwalakwa, Chrissie; Singh, Lauren; Brenna, J. Thomas; Manary, Mark J.

    2015-01-01

    Objective Ready-to-use therapeutic food (RUTF) is the preferred treatment for uncomplicated severe acute malnutrition. RUTF contains large amounts of linoleic acid and very little α-linolenic acid, which may reduce the availability of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) to the recovering child. A novel high oleic RUTF (HO-RUTF) was developed with less linoleic acid to determine its effect on DHA and EPA status. Methods We conducted a prospective, randomized, double-blinded, clinical effectiveness trial treating rural Malawian children with severe acute malnutrition. Children were treated with either HO-RUTF or standard RUTF. Plasma phospholipid (PL) fatty acid status was measured upon enrollment and after 4 weeks and compared between the two intervention groups. Results Among the 141 children enrolled, 48/71 receiving HO-RUTF and 50/70 receiving RUTF recovered. Plasma PL samples were analyzed from 43 children consuming HO-RUTF and 35 children consuming RUTF. The change in DHA content during the first 4 weeks was +4% and −25% in the HO-RUTF and RUTF groups, respectively (P = 0.04). For EPA, the change in content was 63% and −24% in the HO-RUTF and RUTF groups (P < 0.001). For arachidonic acid, the change in content was −3% and 13% in the HO-RUTF and RUTF groups (P < 0.009). Conclusions The changes in DHA and EPA seen in the children treated with HO-RUTF warrant further investigation as they suggest HO-RUTF support improved PUFA status, necessary for neural development and recovery. PMID:25633498

  19. The Cycad Genotoxin MAM Modulates Brain Cellular Pathways Involved in Neurodegenerative Disease and Cancer in a DNA Damage-Linked Manner

    PubMed Central

    Bammler, Theodor K.; Beyer, Richard P.; Churchwell, Mona; Doerge, Daniel R.; Meira, Lisiane B.; Palmer, Valerie S.; Ramos-Crawford, Ana-Luiza; Ren, Xuefeng; Sullivan, Robert C.; Kavanagh, Terrance J.; Samson, Leona D.; Zarbl, Helmut

    2011-01-01

    Methylazoxymethanol (MAM), the genotoxic metabolite of the cycad azoxyglucoside cycasin, induces genetic alterations in bacteria, yeast, plants, insects and mammalian cells, but adult nerve cells are thought to be unaffected. We show that the brains of adult C57BL6 wild-type mice treated with a single systemic dose of MAM acetate display DNA damage (O6-methyldeoxyguanosine lesions, O6-mG) that remains constant up to 7 days post-treatment. By contrast, MAM-treated mice lacking a functional gene encoding the DNA repair enzyme O6-mG DNA methyltransferase (MGMT) showed elevated O6-mG DNA damage starting at 48 hours post-treatment. The DNA damage was linked to changes in the expression of genes in cell-signaling pathways associated with cancer, human neurodegenerative disease, and neurodevelopmental disorders. These data are consistent with the established developmental neurotoxic and carcinogenic properties of MAM in rodents. They also support the hypothesis that early-life exposure to MAM-glucoside (cycasin) has an etiological association with a declining, prototypical neurodegenerative disease seen in Guam, Japan, and New Guinea populations that formerly used the neurotoxic cycad plant for food or medicine, or both. These findings suggest environmental genotoxins, specifically MAM, target common pathways involved in neurodegeneration and cancer, the outcome depending on whether the cell can divide (cancer) or not (neurodegeneration). Exposure to MAM-related environmental genotoxins may have relevance to the etiology of related tauopathies, notably, Alzheimer's disease. PMID:21731631

  20. The Multispectral Atmospheric Mapping Sensor (MAMS): Instrument description, calibration and data quality

    NASA Technical Reports Server (NTRS)

    Jedlovec, G. J.; Menzel, W. P.; Atkinson, R.; Wilson, G. S.; Arvesen, J.

    1986-01-01

    A new instrument has been developed to produce high resolution imagery in eight visible and three infared spectral bands from an aircraft platform. An analysis of the data and calibration procedures has shown that useful data can be obtained at up to 50 m resolution with a 2.5 milliradian aperture. Single sample standard errors for the measurements are 0.5, 0.2, and 0.9 K for the 6.5, 11.1, and 12.3 micron spectral bands, respectively. These errors are halved when a 5.0 milliradian aperture is used to obtain 100 m resolution data. Intercomparisons with VAS and AVHRR measurements show good relative calibration. MAMS development is part of a larger program to develop multispectral Earth imaging capabilities from space platforms during the 1990s.

  1. The Impact of Malnutrition on Intelligence at 3 and 11 Years of Age: The Mediating Role of Temperament

    ERIC Educational Resources Information Center

    Venables, Peter H.; Raine, Adrian

    2016-01-01

    Previous work has shown that malnutrition has deleterious effects on both IQ and aspects of temperament. It is hypothesized that while malnutrition bears a direct relation to IQ, aspects of temperament are also involved in a mediating role so that they produce indirect associations between malnutrition and IQ. The study examines the association of…

  2. Inpatient management of severe malnutrition: time for a change in protocol and practice.

    PubMed

    Brewster, D R

    2011-01-01

    This review focuses on how to reduce the high mortality of severe acute malnutrition (SAM) in African hospitals. The World Health Organization's 1999 manual for physicians (protocol) has not resulted in case-fatality rates of under 5%, even in published research studies from Africa, far less in district and central hospitals which do not record case-fatality rates. It is suggested that the following eight changes to the protocol need to be considered if we are serious about reducing case-fatality rates in African hospitals: (1) use of low lactose, low osmolality milk feeds during the early stage of treatment, especially for HIV-exposed infants and diarrhoeal cases; (2) more cautious use of high carbohydrate loads (ORS, ReSoMal, sucrose and 10% dextrose) during initial stabilisation; (3) more careful grading up and down of feed volumes according the child's responses during the early rehabilitation phase; (4) rapid rehydration of children in shock with Ringer's lactate, as for well-nourished children, with closer monitoring for heart failure; (5) greater use of 3rd-generation cephalosporin and fluoroquinolone antibiotics (e.g. ceftriaxone, ciprofloxacin) to treat sepsis owing to resistant organisms; (6) consider adding glutamine-arginine supplements as gut-protective agents in addition to zinc and vitamin A; (7) the addition of phosphate to existing potassium and magnesium supplements for those at risk of the refeeding syndrome; and (8) introduce better tools for diagnosis and clearer management of combined HIV and tuberculous infections in infants. Many will argue that these suggestions are unaffordable or impractical. On the contrary, cases of SAM requiring hospital admission need to be allocated more resources, including better nursing care, better diet and better medication. Resources made available for other childhood inpatient services such as ID and HIV dwarf those for severe malnutrition. Of course, prevention is always a better investment, including

  3. Improving nutrition in older people in acute care.

    PubMed

    Best, Carolyn; Hitchings, Helen

    2015-07-22

    Older people have an increased risk of becoming malnourished when they are ill. Admission to hospital may affect their nutritional intake and nutritional status. Nutrition screening and implementation of nutrition care plans can help minimise the risk of malnutrition in acute care settings, if used effectively. The nutritional care provided to older inpatients should be timely, co-ordinated, reviewed regularly and communicated effectively between healthcare professionals and across shifts. This article explores what malnutrition means, why older people in hospital might be at risk of malnutrition and the effect hospital admission might have on nutrition and fluid intake. It makes suggestions for addressing these issues, encourages nurses to look at the nutritional care provided in their clinical area, to reflect on what they do well and consider what can be done to improve patients' experiences. PMID:26198529

  4. Moderate malnutrition in rats induces somatic gene mutations.

    PubMed

    Pacheco-Martínez, M Monserrat; Cortés-Barberena, Edith; Cervantes-Ríos, Elsa; Del Carmen García-Rodríguez, María; Rodríguez-Cruz, Leonor; Ortiz-Muñiz, Rocío

    2016-07-01

    The relationship between malnutrition and genetic damage has been widely studied in human and animal models, leading to the observation that interactions between genotoxic exposure and micronutrient status appear to affect genomic stability. A new assay has been developed that uses the phosphatidylinositol glycan class A gene (Pig-a) as a reporter for measuring in vivo gene mutation. The Pig-a assay can be employed to evaluate mutant frequencies (MFs) in peripheral blood reticulocytes (RETs) and erythrocytes (RBCs) using flow cytometry. In the present study, we assessed the effects of malnutrition on mutagenic susceptibility by exposing undernourished (UN) and well-nourished (WN) rats to N-ethyl-N-nitrosourea (ENU) and measuring Pig-a MFs. Two week-old UN and WN male Han-Wistar rats were treated daily with 0, 20, or 40mg/kg ENU for 3 consecutive days. Blood was collected from the tail vein one day before ENU treatment (Day-1) and after ENU administration on Days 7, 14, 21, 28, 35, 42, 49, 56 and 63. Pig-a MFs were measured in RETs and RBCs as the RET(CD59-) and RBC(CD59-) frequencies. In the vehicle control groups, the frequencies of mutant RETs and RBCs were significantly higher in UN rats compared with WN rats at all sampling times. The ENU treatments increased RET and RBC MFs starting at Day 7. Although ENU-induced Pig-a MFs were consistently lower in UN rats than in WN rats, these differences were not significant. To understand these responses, further studies should use other mutagens and nucleated surrogate cells and examine the types of mutations induced in UN and WN rats. PMID:26994962

  5. Comparative Assessment of Fetal Malnutrition by Anthropometry and CAN Score

    PubMed Central

    Soundarya, Mahalingam; Basavaprabhu, Achappa; Raghuveera, Kamila; Baliga, BS; Shivanagaraja, BSV

    2012-01-01

    Objectives Fetal malnutrition (FM) implies soft tissue wasting at birth with significant postnatal consequences and morbidity, and is identified by clinical assessment (CAN score) and anthropometry. No previous studies have been done to study all these parameters and evolve a screening method. The aim of this study was identifying the incidence of FM using CAN score and compare the nutritional assessment with anthropometry and evolve a screening tool for rapid assessment of FM. Methods Prospective study in Government district maternity hospital. 300 term newborns were assessed by CAN score and anthropometry recorded. The newborns were classified as per weight for age. Ponderal index (PI), Body mass index (BMI) and midarm circumference/head circumference ratio (MAC/HC) calculated and compared to CAN Score for accuracy in identifying FM. Findings Incidence of FM was 24%. Newborns identified malnourished by PI, BMI, MAC/HC were evaluated by CAN score and significant number of them (31/78 in PI, 60/121 in BMI, 51/81 in MAC/HC) were found well nourished. Similarly those recognized as normal by PI, BMI, MAC/HC were malnourished by CAN score(25/222 in PI, 11/179 in BMI, 42/219 in MAC/HC) with statistical significance(0.0001). BMI had the highest sensitivity and 11 neonates with normal BMI had low CAN score ann 9 of them had normal PI also making a combination of BMI and PI a good indicator of normal nutrition. Conclusion FM is best identified by CAN Score. BMI is the best screening tool for malnutrition and when coupled with PI will identify most normally nourished newborns. PMID:23056862

  6. [Child malnutrition and maternal overweight in same households in poor urban areas of Benin].

    PubMed

    Deleuze Ntandou Bouzitou, Gervais; Fayomi, Benjamin; Delisle, Hélène

    2005-01-01

    of 13 different food groups in the previous week, a food diversity score was computed. Overall 35.5% of children were malnourished, and school-age children had a worse nutritional status than under-5 children: 41% and 30% PEM (chronic or acute or both), respectively. The rate of maternal overweight was 39.1% including 15.5% of obesity. Child PEM coexisted with maternal overweight or obesity in 16.2% of the households; 27.7% of households had PEM only, 23% overweight only, 20.3% showed no malnutrition or overweight, and 12.8% had an underweight mother. Maternal BMI status was significantly associated with both children's weight-for-height z-score, particularly the elder one. The rate of child malnutrition, particularly wasting, was significantly higher among underweight mothers and lower in overweight mothers . Underweight mothers were merged with mothers with BMI < or = 25 for the remaining analyses. Households with overweight mothers tended to enjoy relatively better socio-economic conditions--higher SES, higher maternal education, less food insecurity, better household sanitation; they also tended to have a more diversified diet. This is in contrast with PEM households. Dual burden households shared several socio-economic features with the PEM households, except for a higher (not significant) SES score. Dual burden households also had the lowest food diversity score of all household types. Logistical regression models revealed that a relatively higher SES level was associated with a higher likelihood of maternal overweight in PEM households, whereas poor household sanitation increased the odds of PEM among maternal overweight households. Food diversity appeared significantly associated with a lower likelihood of dual burden in all types of households. The study highlights the importance of addressing the double burden of malnutrition and overweight even in poor areas of low income countries of West Africa. It suggests that prevention efforts should be aimed at

  7. Child malnutrition and deprivation--observations in Guatemala and Costa Rica.

    PubMed

    Mata, L J

    1980-01-01

    Traditional populations consisting of small tribal groups living in close contact with nature may be virtually free from endemic malnutrition owing to the relative absence of infectious diseases. Transition toward modern ways of life and population growth, leading to crowding and underdevelopment, favours endemic malnutrition due to the interaction of malnutrition and infection. Although important features of the traditional culture--breast-feeding, protective child rearing--may remain intact, they are not enough, and such populations exhibit high rates of infectious disease, malnutrition and premature death. In modern industrialized societies, malnutrition often appears related to child abuse and neglect. Organic and metabolic forms are observed but social pathology appears to be the main determinant of most malnutrition observed. Prevention and control of malnutrition requires improvement of the environment and interventions applied in a holistic manner. Emphasis should be given to education and maternal technology, and to promotion of mother-infant interactions, breast-feeding, adequate weaning procedures and detection of factors that may lead to child deprivation and abuse. Improvement is feasible for most developing nations if social forces become conscious of the needed changes, but positive elements of traditinal culture should be preserved. PMID:6816638

  8. Protein-energy malnutrition in the rehabilitation setting: Evidence to improve identification.

    PubMed

    Marshall, Skye

    2016-04-01

    Methods of identifying malnutrition in the rehabilitation setting require further examination so that patient outcomes may be improved. The purpose of this narrative review was to: (1) examine the defining characteristics of malnutrition, starvation, sarcopenia and cachexia; (2) review the validity of nutrition screening tools and nutrition assessment tools in the rehabilitation setting; and (3) determine the prevalence of malnutrition in the rehabilitation setting by geographical region and method of diagnosis. A narrative review was conducted drawing upon international literature. Starvation represents one form of malnutrition. Inadequate energy and protein intake are the critical factor in the aetiology of malnutrition, which is distinct from sarcopenia and cachexia. Eight nutrition screening tools and two nutrition assessment tools have been evaluated for criterion validity in the rehabilitation setting, and consideration must be given to the resources of the facility and the patient group in order to select the appropriate tool. The prevalence of malnutrition in the rehabilitation setting ranges from 14-65% worldwide with the highest prevalence reported in rural, European and Australian settings. Malnutrition is highly prevalent in the rehabilitation setting, and consideration must be given to the patient group when determining the most appropriate method of identification so that resources may be used efficaciously and the chance of misdiagnosis minimised. PMID:26921933

  9. The implication of protein malnutrition on cardiovascular control systems in rats

    PubMed Central

    Silva, Fernanda C.; de Menezes, Rodrigo C.; Chianca, Deoclécio A.

    2015-01-01

    The malnutrition in early life is associated with metabolic changes and cardiovascular impairment in adulthood. Deficient protein intake-mediated hypertension has been observed in clinical and experimental studies. In rats, protein malnutrition also increases the blood pressure and enhances heart rate and sympathetic activity. In this review, we discuss the effects of post-weaning protein malnutrition on the resting mean arterial pressure and heart rate and their variabilities, cardiovascular reflexes sensitivity, cardiac autonomic balance, sympathetic and renin-angiotensin activities and neural plasticity during adult life. These insights reveal an interesting prospect on the autonomic modulation underlying the cardiovascular imbalance and provide relevant information on preventing cardiovascular diseases. PMID:26388783

  10. The HtrA/DegP family protease MamE is a bifunctional protein with roles in magnetosome protein localization and magnetite biomineralization

    PubMed Central

    Quinlan, Anna; Murat, Dorothée; Vali, Hojatollah; Komeili, Arash

    2011-01-01

    Summary Magnetotactic bacteria contain nanometer-sized, membrane-bound organelles, called magnetosomes, which are tasked with the biomineralization of small crystals of the iron oxide magnetite allowing the organism to use geomagnetic field lines for navigation. A key player in this process is the HtrA/DegP family protease MamE. In its absence, Magnetospirillum magneticum str AMB-1 is able to form magnetosome membranes but not magnetite crystals, a defect previously linked to the mislocalization of magnetosome proteins. In this work we use a directed genetic approach to find that MamE, and another predicted magnetosome-associated protease, MamO, likely function as proteases in vivo. However, as opposed to the complete loss of mamE where no biomineralization is observed, the protease-deficient variant of this protein still supports the initiation and formation of small, 20 nm-sized crystals of magnetite, too small to hold a permanent magnetic dipole moment. This analysis also reveals that MamE is a bifunctional protein with a protease-independent role in magnetosome protein localization and a protease-dependent role in maturation of small magnetite crystals. Together these results imply the existence of a previously unrecognized “checkpoint” in biomineralization where MamE moderates the completion of magnetite formation and thus committal to magneto-aerotaxis as the organism’s dominant mode of navigating the environment. PMID:21414040

  11. Genetic and biochemical investigations of the role of MamP in redox control of iron biomineralization in Magnetospirillum magneticum

    PubMed Central

    Jones, Stephanie R.; Wilson, Tiffany D.; Brown, Margaret E.; Rahn-Lee, Lilah; Yu, Yi; Fredriksen, Laura L.; Ozyamak, Ertan; Komeili, Arash; Chang, Michelle C. Y.

    2015-01-01

    Magnetotactic bacteria have evolved complex subcellular machinery to construct linear chains of magnetite nanocrystals that allow the host cell to sense direction. Each mixed-valent iron nanoparticle is mineralized from soluble iron within a membrane-encapsulated vesicle termed the magnetosome, which serves as a specialized compartment that regulates the iron, redox, and pH environment of the growing mineral. To dissect the biological components that control this process, we have carried out a genetic and biochemical study of proteins proposed to function in iron mineralization. In this study, we show that the redox sites of c-type cytochromes of the Magnetospirillum magneticum AMB-1 magnetosome island, MamP and MamT, are essential to their physiological function and that ablation of one or both heme motifs leads to loss of function, suggesting that their ability to carry out redox chemistry in vivo is important. We also develop a method to heterologously express fully heme-loaded MamP from AMB-1 for in vitro biochemical studies, which show that its Fe(III)–Fe(II) redox couple is set at an unusual potential (−89 ± 11 mV) compared with other related cytochromes involved in iron reduction or oxidation. Despite its low reduction potential, it remains competent to oxidize Fe(II) to Fe(III) and mineralize iron to produce mixed-valent iron oxides. Finally, in vitro mineralization experiments suggest that Mms mineral-templating peptides from AMB-1 can modulate the iron redox chemistry of MamP. PMID:25775527

  12. The Influence of Early Protein Energy Malnutrition on Subsequent Behavior and Intellectual Performance.

    ERIC Educational Resources Information Center

    Gupta, Sarita

    1990-01-01

    Protein-energy malnutrition in early childhood, as seen in many developing countries, influences subsequent behavior and intellectual performance. These impairments are associated with further reduction in fine motor skills and academic performance. (Author)

  13. [Poverty, child malnutrition and morbidity in urban area families from Gran La Plata, Buenos Aires].

    PubMed

    Ortale, S; Rodrigo, M A

    1998-06-01

    A comparative study was carried out over two samples of 50 families each. Both groups belong to the low income social level from Gran La Plata. One of the groups was made up of families in which at least one child suffer malnutrition. The other group of families did not present children under malnutrition conditions. Differences sociodemographic, economic and environmental factors are identified. At the same time, a strong link between primary malnutrition and an increase in children morbility and mortality was found. The results obtained demonstrate that the lack of programmes that these cases deserve, have a high social and economic cost, as malnutrition treatment demand a higher budget than its prevention. PMID:9830490

  14. Pediatric Patients' Malnutrition and Its Relation to Hospitalization Times and Causes.

    ERIC Educational Resources Information Center

    Guimarey, Luis M.; And Others

    1984-01-01

    Relates the nutritional status of 1,378 hospitalized pediatric patients to length of hospitalization and definitive hospitalization diagnosis. Findings indicated the length of hospitalization time increased markedly with malnutrition, especially for patients with diarrhea. (BJD)

  15. Gastrointestinal Manifestations, Malnutrition, and Role of Enteral and Parenteral Nutrition in Patients With Scleroderma.

    PubMed

    Bharadwaj, Shishira; Tandon, Parul; Gohel, Tushar; Corrigan, Mandy L; Coughlin, Kathleen L; Shatnawei, Abdullah; Chatterjee, Soumya; Kirby, Donald F

    2015-08-01

    Scleroderma (systemic sclerosis) is an autoimmune disease that can affect multiple organ systems. Gastrointestinal (GI) involvement is the most common organ system involved in scleroderma. Complications of GI involvement including gastroesophageal reflux disease, small intestinal bacterial overgrowth, and chronic intestinal pseudoobstruction secondary to extensive fibrosis may lead to nutritional deficiencies in these patients. Here, we discuss pathophysiology, progression of GI manifestations, and malnutrition secondary to scleroderma, and the use of enteral and parenteral nutrition to reverse severe nutritional deficiencies. Increased mortality in patients with concurrent malnutrition in systemic sclerosis, as well as the refractory nature of this malnutrition to pharmacologic therapies compels clinicians to provide novel and more invasive interventions in reversing these nutritional deficiencies. Enteral and parenteral nutrition have important implications for patients who are severely malnourished or have compromised GI function as they are relatively safe and have substantial retrospective evidence of success. Increased awareness of these therapeutic options is important when treating scleroderma-associated malnutrition. PMID:25992813

  16. Malnutrition in a Modernising Economy: The Changing Aetiology and Epidemiology of Malnutrition in an African Kingdom, Buganda c.1940–73

    PubMed Central

    Nott, John

    2016-01-01

    The ecological fecundity of the northern shore of Lake Victoria was vital to Buganda’s dominance of the interlacustrine region during the pre-colonial period. Despite this, protein-energy malnutrition was notoriously common throughout the twentieth century. This paper charts changes in nutritional illness in a relatively wealthy, food-secure area of Africa during a time of vast social, economic and medical change. In Buganda at least, it appears that both the causation and epidemiology of malnutrition moved away from the endemic societal causes described by early colonial doctors and became instead more defined by individual position within a rapidly modernising economy. PMID:26971598

  17. Malnutrition in a Modernising Economy: The Changing Aetiology and Epidemiology of Malnutrition in an African Kingdom, Buganda c.1940-73.

    PubMed

    Nott, John

    2016-04-01

    The ecological fecundity of the northern shore of Lake Victoria was vital to Buganda's dominance of the interlacustrine region during the pre-colonial period. Despite this, protein-energy malnutrition was notoriously common throughout the twentieth century. This paper charts changes in nutritional illness in a relatively wealthy, food-secure area of Africa during a time of vast social, economic and medical change. In Buganda at least, it appears that both the causation and epidemiology of malnutrition moved away from the endemic societal causes described by early colonial doctors and became instead more defined by individual position within a rapidly modernising economy. PMID:26971598

  18. Possible causes of malnutrition in Melghat, a tribal region of Maharashtra, India.

    PubMed

    Birdi, Tannaz J; Joshi, Sujay; Kotian, Shrati; Shah, Shimoni

    2014-09-01

    Melghat, situated in Amravati District of Maharashtra, India is a tribal region with amongst the highest numbers of malnutrition cases. This paper focuses on possible causes of malnutrition in the Dharni block of Melghat. Quantitative survey recorded the existing burden of malnutrition, kitchen garden (KG) practices, Public Distribution System, food provisioning, Anganwadi services and hygiene/sanitation in the community. Additionally a qualitative study was undertaken to understand the community's perspective on nutrition, cultural beliefs, spending habits and other factors contributing to malnutrition. Malnutrition was found to be highly prevalent amongst all age groups with 54% children aged 1-5 years and 43% adults aged ≥ 20 years being severe to moderately underweight. A major cause for malnutrition in children was faulty child care practices. Data on food provisioning revealed that while the caloric needs of the community were substantially met by consumption of cereals and pulses, minimal consumption of green leafy vegetables (GLVs) could lead to micronutrient deficiency in the community. KGs, which provide GLVs, were mainly cultivated in monsoon (98%) which declined to merely 4% in summer. The benefits of government schemes though targeted at malnourished children were often shared by the entire household and thus got diluted. Key finding was that nutrition interventions should be designed to address the entire household and emphasis should be given to appropriate nutrition education, without which distributing food or increasing income would have minimal effect. PMID:25168997

  19. Possible Causes of Malnutrition in Melghat, a Tribal Region of Maharashtra, India

    PubMed Central

    Birdi, Tannaz J.; Joshi, Sujay; Kotian, Shrati; Shah, Shimoni

    2014-01-01

    Melghat, situated in Amravati District of Maharashtra, India is a tribal region with amongst the highest numbers of malnutrition cases. This paper focuses on possible causes of malnutrition in the Dharni block of Melghat. Quantitative survey recorded the existing burden of malnutrition, kitchen garden (KG) practices, Public Distribution System, food provisioning, Anganwadi services and hygiene/sanitation in the community. Additionally a qualitative study was undertaken to understand the community’s perspective on nutrition, cultural beliefs, spending habits and other factors contributing to malnutrition. Malnutrition was found to be highly prevalent amongst all age groups with 54% children aged 1-5 years and 43% adults aged ≥ 20 years being severe to moderately underweight. A major cause for malnutrition in children was faulty child care practices. Data on food provisioning revealed that while the caloric needs of the community were substantially met by consumption of cereals and pulses, minimal consumption of green leafy vegetables (GLVs) could lead to micronutrient deficiency in the community. KGs, which provide GLVs, were mainly cultivated in monsoon (98%) which declined to merely 4% in summer. The benefits of government schemes though targeted at malnourished children were often shared by the entire household and thus got diluted. Key finding was that nutrition interventions should be designed to address the entire household and emphasis should be given to appropriate nutrition education, without which distributing food or increasing income would have minimal effect. PMID:25168997

  20. Understanding the gastrointestinal tract of the elderly to develop dietary solutions that prevent malnutrition

    PubMed Central

    Rémond, Didier; Shahar, Danit R.; Gille, Doreen; Pinto, Paula; Kachal, Josefa; Peyron, Marie-Agnès; Dos Santos, Claudia Nunes; Walther, Barbara; Bordoni, Alessandra; Dupont, Didier; Tomás-Cobos, Lidia; Vergères, Guy

    2015-01-01

    Although the prevalence of malnutrition in the old age is increasing worldwide a synthetic understanding of the impact of aging on the intake, digestion, and absorption of nutrients is still lacking. This review article aims at filling the gap in knowledge between the functional decline of the aging gastrointestinal tract (GIT) and the consequences of malnutrition on the health status of elderly. Changes in the aging GIT include the mechanical disintegration of food, gastrointestinal motor function, food transit, chemical food digestion, and functionality of the intestinal wall. These alterations progressively decrease the ability of the GIT to provide the aging organism with adequate levels of nutrients, what contributes to the development of malnutrition. Malnutrition, in turn, increases the risks for the development of a range of pathologies associated with most organ systems, in particular the nervous-, muscoskeletal-, cardiovascular-, immune-, and skin systems. In addition to psychological, economics, and societal factors, dietary solutions preventing malnutrition should thus propose dietary guidelines and food products that integrate knowledge on the functionality of the aging GIT and the nutritional status of the elderly. Achieving this goal will request the identification, validation, and correlative analysis of biomarkers of food intake, nutrient bioavailability, and malnutrition. PMID:26091351

  1. Micronutrients in the treatment of stunting and moderate malnutrition.

    PubMed

    Penny, Mary Edith

    2012-01-01

    Linear growth retardation or stunting may occur with or without low weight-for-age, but in both cases stunted or moderately malnourished children are deficient in micronutrients. Pregnancy and the first 2 years are critical periods. Dietary deficiency of zinc, iron, calcium, and vitamin A are especially common and often occur together. Zinc is essential for adequate growth, and supplements have been shown to increase intrauterine femur length and to prevent stunting. However, in general, supplements which provide a mixture of micronutrients have been more successful in preventing stunting and are simpler to take and distribute. Multiple micronutrients together with energy and macronutrients are also needed for the management of moderate malnutrition. Multiple micronutrients may be delivered as medicinal-like supplements, but may also be combined with food, for instance in milk drinks, in fortified dried cereal mixes used to supplement complementary foods or in lipid nutrition supplements. The latter also provide essential fats necessary for growth. Micronutrient powders for home fortification are effective in preventing anemia, but present combinations do not prevent stunting. Improving the diets of infant and young children is also possible, and increased intake of animal source foods can improve growth. PMID:25825290

  2. The Arid Melancholy-Netherton Syndrome With Protein Energy Malnutrition.

    PubMed

    Jain, Sonia Pramod; Jain, Pramod Ajit; Pandey, Neha

    2016-04-01

    Netherton Syndrome (NS) is a rare autosomal recessive hereditary ichthyosiform disease with a classical triad comprising of an ichthyosiform dermatosis, hair shaft abnormalities and atopic diathesis. There is a mutation in a gene named Serine Protease Inhibitor Kazal type-5 (SPINK5); a new type of serine protease inhibitor involved in the regulation of skin barrier formation and immunity. Skin manifestations include, Ichthyosis Linearis Circumflexa (ILC), polycyclic and serpiginous, erythematous plaques with characteristic migratory, double-edged scale at the margins, or Congenital Ichthyosiform Erythroderma (CIE). Most of the patients have elevated immunoglobulin class E (IgE) and show atopic manifestations. Hair shaft abnormalities like pili torti and/or trichorrhexis nodosa, trichorrhexis invaginata, are seen. Here, we report a rare case of Netherton Syndrome having ILC and trichorrhexis nodosa with protein energy malnutrition in a five-year-old school going girl. She belonged to a poor socio-economic background and was worried about her physical appearance due to her skin lesions, causing psychosocial morbidity to her. PMID:27190931

  3. The Arid Melancholy-Netherton Syndrome With Protein Energy Malnutrition

    PubMed Central

    Jain, Pramod Ajit; Pandey, Neha

    2016-01-01

    Netherton Syndrome (NS) is a rare autosomal recessive hereditary ichthyosiform disease with a classical triad comprising of an ichthyosiform dermatosis, hair shaft abnormalities and atopic diathesis. There is a mutation in a gene named Serine Protease Inhibitor Kazal type-5 (SPINK5); a new type of serine protease inhibitor involved in the regulation of skin barrier formation and immunity. Skin manifestations include, Ichthyosis Linearis Circumflexa (ILC), polycyclic and serpiginous, erythematous plaques with characteristic migratory, double-edged scale at the margins, or Congenital Ichthyosiform Erythroderma (CIE). Most of the patients have elevated immunoglobulin class E (IgE) and show atopic manifestations. Hair shaft abnormalities like pili torti and/or trichorrhexis nodosa, trichorrhexis invaginata, are seen. Here, we report a rare case of Netherton Syndrome having ILC and trichorrhexis nodosa with protein energy malnutrition in a five-year-old school going girl. She belonged to a poor socio-economic background and was worried about her physical appearance due to her skin lesions, causing psychosocial morbidity to her. PMID:27190931

  4. The effectiveness of nutritional interventions in malnutrition and cachexia.

    PubMed

    Baldwin, Christine

    2015-11-01

    Cancer is a common diagnosis and leading cause of death worldwide. Amounts of weight loss vary but it is associated with considerable morbidity, poorer quality of life and reduced survival. Nutritional intervention has the potential to maximise response to treatment and improve functioning and quality of life. The aim of this paper was to review the evidence for oral nutritional interventions in the management of weight loss in patients with cancer. Comparison of studies of nutritional support interventions in people with cancer is complicated by variations in understanding of what constitutes a compromised nutritional status. There are similarities and differences between definitions of both malnutrition and cachexia and studies of oral nutritional interventions have failed to use standard criteria at study inclusion contributing to heterogeneity amongst studies. Meta-analysis of randomised controlled trials has suggested limited evidence of benefit to nutritional and clinical outcomes but some improvements to aspects of quality of life. The presence of cachexia in patients with cancer might explain the limited efficacy of simple oral nutritional interventions, which lack a component designed to address metabolic abnormalities associated with cachexia. Novel strategies combining nutritional support with therapeutic agents designed to down-regulate the metabolic aberrations have failed to demonstrate consistent benefits and the results of multimodal treatments combining several interventions are awaited. There is a need for intervention studies recruiting patients early in the disease course, which underlines the need for definitions which predict poor outcome and hence allow early recognition of vulnerable patients. PMID:26087760

  5. Evaluation of dental age in protein energy malnutrition children

    PubMed Central

    Kumar, Vinod; Patil, Kavitha; Munoli, Karishma

    2015-01-01

    Background: Knowledge of dental age is very essential for a dental practitioner in planning treatment and it is a supplementary source of information for Pediatrician, Orthopedician and Endocrinologist. There are few studies in the literature about the comparison of dental with chronological age in protein energy malnutrition children (PEM). Accordingly, the aim of this study was to evaluate and compare dental age and chronological age in PEM children. Aims and Objective: To determine and compare dental age and chronological age in PEM children. Methods: A total of 100 PEM children within the age range of 6–12 years were selected. Chronological age was recorded using date of birth. Dental age was assessed by Demirjian's method using orthopantomogram. Comparison of two ages was done using the unpaired Student's t-test and Pearson's correlation coefficient. Results: Dental age was retarded compared to chronological age, and the difference was statistically significant (P < 0.001). The correlations between two ages were positive in both sexes. Conclusion: Dental age was delayed in our sample of 100 PEM children. Dental age can be considered as variable for diagnosing growth retardation in PEM children. Further studies are required to support our findings. PMID:26538919

  6. Malnutrition and age-specific nutritional management in cystic fibrosis.

    PubMed

    Dodge, J A

    1992-10-01

    Malnutrition is recognised as a major prognostic factor adversely affecting survival in cystic fibrosis (CF) and is the result of an unfavourable energy balance in these patients. A high resting energy expenditure, dependent on the patient's genotype, in addition to pulmonary infection play an important role in producing anorexia and weight loss. Nutritional management with the aim to gain weight and catch up with growth is age-specific. It is important to repair nutritional status as early as possible after diagnosis. In infancy breast feeding is advised with, if necessary, supplemental feeding with predigested formulae such as Pregestimil. In childhood nutritional management must be aimed towards a normal weight gain and growth velocity. The latter is the best guide of nutritional adequacy. If weight gain falters the first principle is to treat any associated respiratory infection, the second is to ensure adequate enzyme therapy and control of steatorrhoea, and only then should dietary energy supplements be introduced. When oral hypernutrition fails, nocturnal naso-gastric tube feeding of a non-elemental formula may be considered. Parenteral nutrition is rarely indicated and should be reserved as a last solution for CF-patients. PMID:1470282

  7. The use of oral nutritional supplements in the acute care setting.

    PubMed

    Ojo, Omorogieva

    2016-06-23

    Oral nutritional supplements offer support to patients in acute care who are undernourished or at risk of malnutrition. Yet doubts remain over cost and compliance. Omorogieva Ojo, Senior Lecturer in Primary Care at University of Greenwich weighs up the evidence. PMID:27345066

  8. Modelling the Contributions of Malaria, HIV, Malnutrition and Rainfall to the Decline in Paediatric Invasive Non-typhoidal Salmonella Disease in Malawi

    PubMed Central

    Feasey, Nicholas A.; Everett, Dean; Faragher, E. Brian; Roca-Feltrer, Arantxa; Kang’ombe, Arthur; Denis, Brigitte; Kerac, Marko; Molyneux, Elizabeth; Molyneux, Malcolm; Jahn, Andreas

    2015-01-01

    Introduction Nontyphoidal Salmonellae (NTS) are responsible for a huge burden of bloodstream infection in Sub-Saharan African children. Recent reports of a decline in invasive NTS (iNTS) disease from Kenya and The Gambia have emphasised an association with malaria control. Following a similar decline in iNTS disease in Malawi, we have used 9 years of continuous longitudinal data to model the interrelationships between iNTS disease, malaria, HIV and malnutrition. Methods Trends in monthly numbers of childhood iNTS disease presenting at Queen’s Hospital, Blantyre, Malawi from 2002 to 2010 were reviewed in the context of longitudinal monthly data describing malaria slide-positivity among paediatric febrile admissions, paediatric HIV prevalence, nutritional rehabilitation unit admissions and monthly rainfall over the same 9 years, using structural equation models (SEM). Results Analysis of 3,105 iNTS episodes identified from 49,093 blood cultures, showed an 11.8% annual decline in iNTS (p < 0.001). SEM analysis produced a stable model with good fit, revealing direct and statistically significant seasonal effects of malaria and malnutrition on the prevalence of iNTS disease. When these data were smoothed to eliminate seasonal cyclic changes, these associations remained strong and there were additional significant effects of HIV prevalence. Conclusions These data suggest that the overall decline in iNTS disease observed in Malawi is attributable to multiple public health interventions leading to reductions in malaria, HIV and acute malnutrition. Understanding the impacts of public health programmes on iNTS disease is essential to plan and evaluate interventions. PMID:26230258

  9. Malnutrition in Community-Dwelling Elderly in Turkey: A Multicenter, Cross-Sectional Study

    PubMed Central

    Gündüz, Ercan; Eskin, Fatih; Gündüz, Mehmet; Bentli, Recep; Zengin, Yılmaz; Dursun, Recep; İçer, Mustafa; Durgun, Hasan Mansur; Gürbüz, Hüseyin; Ekinci, Mustafa; Yeşil, Yusuf; Güloğlu, Cahfer

    2015-01-01

    Background This study aimed to investigate the prevalence of malnutrition and explore the somatic, psychological, functional, and social or lifestyle characteristics linked to malnutrition in elderly people at a hospital in Turkey. Material/Methods This study included 1030 patients older than 65 years of age who were seen at the internal medicine and geriatrics outpatient clinics of the study centers in Istanbul, Ankara, Duzce, Corum, Mardin, Malatya, and Diyarbakir provinces between January and December 2014. All patients underwent Mini Nutritional Assessment (MNA) and Geriatric Depression Scale (GDS) tests via one-on-one interview method. The demographic properties of the patients were also recorded during this interview. Results Among 1030 patients included in this study, 196 (19%) had malnutrition and 300 (29.1%) had malnutrition risk. The malnutrition group and the other groups were significantly different with respect to mean GDS score, income status, educational status, the number of children, functional status (ADL, IADL), the number of patients with depression, and the number of comorbid disorders. According to the results of the logistic regression analysis, age (OR=95% CI: 1.007–1.056; p=0.012), BMI (OR=95% CI: 0.702–0.796; p<0.001), educational status (OR=95% CI: 0.359–0.897; p=0.015), comorbidity (OR=95% CI: 2.296–5.448; p<0.001), and depression score (OR=95% CI: 1.104–3.051; p=0.02) were independently associated with malnutrition. Conclusions Our study demonstrates that age, depression, BMI, comorbidity, and the educational status were independently associated with malnutrition in an elderly population. PMID:26371941

  10. Inflammation-driven malnutrition: a new screening tool predicts outcome in Crohn's disease.

    PubMed

    Jansen, Irene; Prager, Matthias; Valentini, Luzia; Büning, Carsten

    2016-09-01

    Malnutrition is a frequent feature in Crohn's disease (CD), affects patient outcome and must be recognised. For chronic inflammatory diseases, recent guidelines recommend the development of combined malnutrition and inflammation risk scores. We aimed to design and evaluate a new screening tool that combines both malnutrition and inflammation parameters that might help predict clinical outcome. In a prospective cohort study, we examined fifty-five patients with CD in remission (Crohn's disease activity index (CDAI) <200) at 0 and 6 months. We assessed disease activity (CDAI, Harvey-Bradshaw index), inflammation (C-reactive protein (CRP), faecal calprotectin (FC)), malnutrition (BMI, subjective global assessment (SGA), serum albumin, handgrip strength), body composition (bioelectrical impedance analysis) and administered the newly developed 'Malnutrition Inflammation Risk Tool' (MIRT; containing BMI, unintentional weight loss over 3 months and CRP). All parameters were evaluated regarding their ability to predict disease outcome prospectively at 6 months. At baseline, more than one-third of patients showed elevated inflammatory markers despite clinical remission (36·4 % CRP ≥5 mg/l, 41·5 % FC ≥100 µg/g). Prevalence of malnutrition at baseline according to BMI, SGA and serum albumin was 2-16 %. At 6 months, MIRT significantly predicted outcome in numerous nutritional and clinical parameters (SGA, CD-related flares, hospitalisations and surgeries). In contrast, SGA, handgrip strength, BMI, albumin and body composition had no influence on the clinical course. The newly developed MIRT was found to reliably predict clinical outcome in CD patients. This screening tool might be used to facilitate clinical decision making, including treatment of both inflammation and malnutrition in order to prevent complications. PMID:27546478

  11. Poverty, malnutrition, underdevelopment and cardiovascular disease: a South African perspective.

    PubMed

    Vorster, H H; Kruger, A

    2007-01-01

    This article explores possible mechanisms to explain the known relationships between poverty, undernutrition, underdevelopment and cardiovascular disease (CVD) in developing countries. Poverty is a multidimensional concept. It is both a cause and consequence of undernutrition. The article shows how malnutrition during pregnancy could lead to low birth-weight babies, who are not only at increased risk of mental and physical underdevelopment, but also 'programmed' to be at increased risk of CVD and other non-communicable diseases in adult life. The underdevelopment leads to decreased 'human capital and competence' with an inability to create food security and an enabling environment for self and family to escape poverty and undernutrition in the next generation. It is accepted that a lack of education and knowledge in the poor for primary prevention of CVD through healthy eating patterns and lifestyles, as well as limited access to healthcare services for secondary prevention and treatment contribute to CVD. This article postulates that the link between poverty and CVD in South Africa can be explained by the high prevalence of undernutrition in one- to nine year- old children (9% underweight, 23% stunted and 3% wasted), the high prevalence of overweight and obesity in adults (54.5% in white men and 58.5% in African women) as well as the negative trends in nutrient intakes when Africans (the population group with the largest numbers of poor people) urbanise, acculturate and adopt westernised eating patterns that will increase CVD risk. In conclusion, we plead for a holistic, integrated but transdisciplinary and multisectorial approach to break the vicious circle of poverty and undernutrition for the longterm prevention of CVD. PMID:17985032

  12. Trends in socioeconomic inequalities in child malnutrition in Vietnam: findings from the Multiple Indicator Cluster Surveys, 2000–2011

    PubMed Central

    Kien, Vu Duy; Lee, Hwa-Young; Nam, You-Seon; Oh, Juhwan; Giang, Kim Bao; Van Minh, Hoang

    2016-01-01

    Background Child malnutrition is not only a major contributor to child mortality and morbidity, but it can also determine socioeconomic status in adult life. The rate of under-five child malnutrition in Vietnam has significantly decreased, but associated inequality issues still need attention. Objective This study aims to explore trends, contributing factors, and changes in inequalities for under-five child malnutrition in Vietnam between 2000 and 2011. Design Data were drawn from the Viet Nam Multiple Indicator Cluster Survey for the years 2000 and 2011. The dependent variables used for the study were stunting, underweight, and wasting of under-five children. The concentration index was calculated to see the magnitude of child malnutrition, and the inequality was decomposed to understand the contributions of determinants to child malnutrition. The total differential decomposition was used to identify and explore factors contributing to changes in child malnutrition inequalities. Results Inequality in child malnutrition increased between 2000 and 2011, even though the overall rate declined. Most of the inequality in malnutrition was due to ethnicity and socioeconomic status. The total differential decomposition showed that the biggest and second biggest contributors to the changes in underweight inequalities were age and socioeconomic status, respectively. Socioeconomic status was the largest contributor to inequalities in stunting. Conclusions Although the overall level of child malnutrition was improved in Vietnam, there were significant differences in under-five child malnutrition that favored those who were more advantaged in socioeconomic terms. The impact of socioeconomic inequalities in child malnutrition has increased over time. Multifaceted approaches, connecting several relevant ministries and sectors, may be necessary to reduce inequalities in childhood malnutrition. PMID:26950558

  13. A time-lapse lidar survey of the Mam Tor landslide, Derbyshire, UK.

    NASA Astrophysics Data System (ADS)

    Hodgetts, David; Rutter, Ernest

    2013-04-01

    Since 2004 a terrestrial lidar survey of the Mam Tor landslide in Castleton, Derbyshire, has been undertaken each year. Using a Riegl LMSZ420i laser scanner, the data has been collected during the winter months, while the vegetation is at a minimum, to ensure the surveys record a surface as close to the true geometry of the landslip as possible. These surveys, when combined and viewed in sequence provide an accurate record of the landslides movement over this time. The main challenge in comparing yearly scans of a progressively moving feature (at up to 500mm/year) is to ensure that each year's scan is in the correct place relative to the others, to this end features outside of the landslip are used as reference points to ensure consistent cross referencing of the landslip scans. In addition to this each year the laser scanner is sited in the same position within the study area, to ensure the same areal coverage over consecutive years. In-house software called Virtual Reality Geological Studio (VRGS) is used to interpret and analyse the landslip data (in both point cloud and triangulated mesh form), providing tools for comparing surface elevation, but also to tracking individual features (such as individual boulders) from year to year allowing movement vectors to be mapped across the area of the landslip. These vectors can then be compared with other measurements from total-station surveys to act as a check on the validity of the lidar mapping approach. Topographic sections will be shown through several parts of the slip to facilitate year by year comparison. The landslide itself has formed within the Carboniferous Edale Mudstone Formation, is approximately 900m long, 270 to 300m wide and up to 20m thick. The landslip is estimated to be over 3200 years old.

  14. Prevalence of 'being at risk of malnutrition' and associated factors in adult patients receiving nursing care at home in Belgium.

    PubMed

    Geurden, Bart; Franck MPsych, Erik; Lopez Hartmann, Maja; Weyler, Joost; Ysebaert, Dirk

    2015-10-01

    Malnutrition is a known problem in hospitals and nursing homes. This study aims to evaluate the prevalence of being at risk of malnutrition in community living adults receiving homecare nursing and to determine factors independently associated with this risk of malnutrition. Furthermore, it also aimed to describe aspects of current nutritional nursing care. Patients (n = 100) are screened with the Malnutrition Universal Screening Tool to evaluate their risk of malnutrition. A patient survey was used to analyse associated factors. In this population, 29% are at risk for malnutrition. Following a multivariate logistic regression analysis, 'loss of appetite' proved the most important factor. A survey for nurses (n = 61) revealed low awareness, poor knowledge, poor communication between stakeholders and a moderate approach of malnutrition. These findings should encourage homecare nurses to use a recommended screening tool for malnutrition and to actively observe and report loss of appetite to initiate the prescription of individual tailored interventions. Belgian homecare nurses' management does not yet fully comply with international recommendations. Additional training in nutritional nursing care and screening methods for malnutrition is needed. Systematic screening should be further developed and evaluated in this at-risk population. PMID:24810494

  15. Subcellular localization of the magnetosome protein MamC in the marine magnetotactic bacterium Magnetococcus marinus strain MC-1 using immunoelectron microscopy

    SciTech Connect

    Valverde-Tercedor, C; Abada-Molina, F; Martinez-Bueno, M; Pineda-Molina, Estela; Chen, Lijun; Oestreicher, Zachery; Lower, Brian H; Lower, Steven K; Bazylinski, Dennis A; Jimenez-Lopez, C

    2014-04-24

    Magnetotactic bacteria are a diverse group of prokaryotes that biomineralize intracellular magnetosomes, composed of magnetic (Fe3O4) crystals each enveloped by a lipid bilayer membrane that contains proteins not found in other parts of the cell. Although partial roles of some of these magnetosome proteins have been determined, the roles of most have not been completely elucidated, particularly in how they regulate the biomineralization process. While studies on the localization of these proteins have been focused solely on Magnetospirillum species, the goal of the present study was to determine, for the first time, the localization of the most abundant putative magnetosome membrane protein, MamC, in Magnetococcus marinus strain MC-1. MamC was expressed in Escherichia coli and purified. Monoclonal antibodies were produced against MamC and immunogold labeling TEM was used to localize MamC in thin sections of cells of M. marinus. Results show that MamC is located only in the magnetosome membrane of Mc. marinus. Based on our findings and the abundance of this protein, it seems likely that it is important in magnetosome biomineralization and might be used in controlling the characteristics of synthetic nanomagnetite.

  16. Malnutrition-Inflammation Score and Quality of Life in Hemodialysis Patients: Is There Any Correlation?

    PubMed Central

    Sohrabi, Zahra; Eftekhari, Mohammad Hassan; Eskandari, Mohammad Hadi; Rezaeianzadeh, Abbas; Sagheb, Mohammad Mahdi

    2015-01-01

    Background: Malnutrition, inflammation and poor quality of life are prevalent among hemodialysis (HD) patients. Health-related quality of life is an important determinant of hospitalization and mortality in HD patients. Objectives: The aim of this study was to assess the correlation between quality of life and malnutrition-inflammation status according to subjective global assessment (SGA) and malnutrition-inflammation scores (MIS) in HD patients. Patients and Methods: We randomly selected 87 of 180 stable HD patients from two HD centers. Those on hemodialysis for at least three months and with malnutrition according to the SGA scores were included in this study. They were divided into two groups of mild to moderate malnutrition (n = 39) and severe malnutrition (n = 49) based on the SGA scores. Serum levels of transferrin, albumin, blood urea nitrogen, creatinine, kt/v, body mass index and malnutrition-inflammation scores were measured in all patients. Health-related quality of life was assessed by validated short form-12 (SF-12) questionnaire for each patient. These values were compared between the two groups of patients by independent sample t-test and Mann-Whitney U test. The correlations of nutritional variables with SGA and MIS scores were determined by Pearson and Spearman correlation tests. Results: There were no differences in measured parameters between the two groups except for MIS scores. Those with severe malnutrition showed higher MIS scores. All quality of life aspects and total scores (PCS, MCS) (rather than social functioning (SF) aspect) were significantly different between the two groups, which showed lower physical and mental scores in severely-malnourished patients. Physical functioning (PF), role limitations due to physical heath (RP), general health (GH), mental health (MH), SF, role limitation due to emotional health (RE), vitality (VT) aspects and total scores (PCS and MCS) had negative significant correlations with MIS and SGA scores (All P

  17. Malnutrition and infection influence the peripheral blood reticulocyte micronuclei frequency in children.

    PubMed

    Cervantes-Ríos, Elsa; Ortiz-Muñiz, Rocío; Martínez-Hernández, Ana Lidia; Cabrera-Rojo, Lilián; Graniel-Guerrero, Jaime; Rodríguez-Cruz, Leonor

    2012-03-01

    Malnutrition is a serious public health problem that affects approximately one third of all children. Developing countries have the highest incidence of malnourished children, and approximately 60% of deaths that occur in children under five are directly related to malnutrition and associated diseases. The relationship between malnutrition and genetic damage has been widely studied in humans and animal models. The micronucleus (MN) assay is useful in detecting chromosome damage induced by several factors. The aim of this study was to evaluate the effects of infection and malnutrition on the frequency of MN in erythrocytes from the peripheral blood of well-nourished, uninfected (WN) and well-nourished, infected (WNI) children, and moderately malnourished (UNM) and severely malnourished (UNS) children, both with infection, using a flow cytometric analysis technique. The percentage of reticulocytes (RETs) was significantly higher (1.5-fold) in WNI children than well-nourished controls. In addition, the UNS group had a 2.2-fold increase in the percentage of RETs compared to the WNI group. The frequency of micronucleated reticulocytes (MN-RETs) was 2.5 times greater, in WNI group compared to the WN group. These frequencies were significantly higher (1.7- and 2.1-fold) in UNM and UNS, respectively, compared to the WNI group. The results suggest that infection and malnutrition induce DNA damage in children. PMID:22119781

  18. Addressing Disease-Related Malnutrition in Healthcare: A Latin American Perspective.

    PubMed

    Correia, Maria Isabel; Hegazi, Refaat A; Diaz-Pizarro Graf, José Ignacio; Gomez-Morales, Gabriel; Fuentes Gutiérrez, Catalina; Goldin, Maria Fernanda; Navas, Angela; Pinzón Espitia, Olga Lucia; Tavares, Gilmária Millere

    2016-03-01

    Alarmingly high rates of disease-related malnutrition have persisted in hospitals of both emerging and industrialized nations over the past 2 decades, despite marked advances in medical care over this same interval. In Latin American hospitals, the numbers are particularly striking; disease-related malnutrition has been reported in nearly 50% of adult patients in Argentina, Brazil, Chile, Costa Rica, Cuba, Dominican Republic, Ecuador, Mexico, Panama, Paraguay, Peru, Puerto Rico, Venezuela, and Uruguay. The tolls of disease-related malnutrition are high in both human and financial terms-increased infectious complications, higher incidence of pressure ulcers, longer hospital stays, more frequent readmissions, greater costs of care, and increased risk of death. In an effort to draw attention to malnutrition in Latin American healthcare, a feedM.E. Latin American Study Group was formed to extend the reach and support the educational efforts of the feedM.E. Global Study Group. In this article, the feedM.E. Latin American Study Group shows that malnutrition incurs excessive costs to the healthcare systems, and the study group also presents evidence of how appropriate nutrition care can improve patients' clinical outcomes and lower healthcare costs. To achieve the benefits of nutrition for health throughout Latin America, the article presents feedM.E.'s simple and effective Nutrition Care Pathway in English and Spanish as a way to facilitate its use. PMID:25883116

  19. Inflammation but Not Dietary Macronutrients Insufficiency Associated with the Malnutrition-Inflammation Score in Hemodialysis Population

    PubMed Central

    Zhang, Kun; Yuan, Zhimin; Chen, Jianping; Wang, Zhiyu; Wang, Jingfeng; Huang, Hui

    2013-01-01

    Malnutrition is associated with increased risk of mortality in hemodialysis patients. And insufficient dietary intake is the common cause for malnutrition. So, in order to survey the dietary intake of hemodialysis patients and study the relationship between the dietary feature and nutritional status, a cross-sectional study was performed. 75 hemodialysis patients from South China participated in the dietary intake survey and nutrition assessment. A three-day diet diary record was used to estimate the major dietary macronutrients. Nutritional status was assessed by malnutrition-inflammation score (MIS) in addition to several related anthropometric measurements. Serum albumin, transferrin, and high-sensitivity C-reactive protein (CRP) were measured. Receiver operating characteristic (ROC) curve analysis was used to quantify the assessing value of independent parameters for nutritional status. The results showed that 48% patients were malnourished according to the MIS. The malnourished patients had a lower body mass index (BMI), fat mass (FM), albumin and a higher level of CRP, compared with normal nourished patients (P < 0.05). However, no significant differences of macronutrients (calories, protein, fat, carbohydrates, etc) were found between the two nutrition groups (P > 0.05). The multivariate regression analysis showed that the major macronutrients had no significant association with MIS (P > 0.05). In conclusion, malnutrition is very common in South China hemodialysis population and these data indicated that inflammation but not dietary macronutrients insufficiency might be the candidate cause for malnutrition in hemodialysis population. PMID:24349471

  20. The Double Burden of Obesity and Malnutrition in a Protracted Emergency Setting: A Cross-Sectional Study of Western Sahara Refugees

    PubMed Central

    Grijalva-Eternod, Carlos S.; Wells, Jonathan C. K.; Cortina-Borja, Mario; Salse-Ubach, Nuria; Tondeur, Mélody C.; Dolan, Carmen; Meziani, Chafik; Wilkinson, Caroline; Spiegel, Paul; Seal, Andrew J.

    2012-01-01

    Background Households from vulnerable groups experiencing epidemiological transitions are known to be affected concomitantly by under-nutrition and obesity. Yet, it is unknown to what extent this double burden affects refugee populations dependent on food assistance. We assessed the double burden of malnutrition among Western Sahara refugees living in a protracted emergency. Methods and Findings We implemented a stratified nutrition survey in October–November 2010 in the four Western Sahara refugee camps in Algeria. We sampled 2,005 households, collecting anthropometric measurements (weight, height, and waist circumference) in 1,608 children (6–59 mo) and 1,781 women (15–49 y). We estimated the prevalence of global acute malnutrition (GAM), stunting, underweight, and overweight in children; and stunting, underweight, overweight, and central obesity in women. To assess the burden of malnutrition within households, households were first classified according to the presence of each type of malnutrition. Households were then classified as undernourished, overweight, or affected by the double burden if they presented members with under-nutrition, overweight, or both, respectively. The prevalence of GAM in children was 9.1%, 29.1% were stunted, 18.6% were underweight, and 2.4% were overweight; among the women, 14.8% were stunted, 53.7% were overweight or obese, and 71.4% had central obesity. Central obesity (47.2%) and overweight (38.8%) in women affected a higher proportion of households than did GAM (7.0%), stunting (19.5%), or underweight (13.3%) in children. Overall, households classified as overweight (31.5%) were most common, followed by undernourished (25.8%), and then double burden–affected (24.7%). Conclusions The double burden of obesity and under-nutrition is highly prevalent in households among Western Sahara refugees. The results highlight the need to focus more attention on non-communicable diseases in this population and balance obesity prevention

  1. Crystallization and preliminary crystallographic analysis of the C-terminal domain of MamM, a magnetosome-associated protein from Magnetospirillum gryphiswaldense MSR-1

    PubMed Central

    Zeytuni, Natalie; Offer, Tal; Davidov, Geula; Zarivach, Raz

    2012-01-01

    MamM is a unique magnetosome-associated protein that shares substantial homology with cation diffusion facilitator (CDF) proteins, a group of heavy-metal-ion efflux transporters that participate in metal-ion homeostasis in all domains of life. Magnetotactic bacteria utilize CDF proteins in iron-oxide biomineralization and in magnetosome formation. Here, the crystallization and preliminary X-ray analysis of recombinant Magnetospirillum gryphiswaldense MamM is reported. The C-terminal domain of MamM was crystallized in the orthorhombic space group C2221, with unit-cell parameters a = 37.1, b = 94.0, c = 53.3 Å. X-ray diffraction data were collected to a resolution of 2.0 Å. PMID:22869124

  2. Acute Bronchitis

    MedlinePlus

    ... or though physical contact (for example, on unwashed hands). Being exposed to tobacco smoke, air pollution, dusts, vapors, and fumes can also cause acute bronchitis. Less often, bacteria can also cause acute bronchitis. To diagnose acute ...

  3. Cystitis - acute

    MedlinePlus

    Uncomplicated urinary tract infection; UTI - acute; Acute bladder infection; Acute bacterial cystitis ... control. Menopause also increases the risk for a urinary tract infection. The following also increase your chances of having ...

  4. [Preventing maternal and child malnutrition: the nutrition component of the Mesoamerican Health Initiative 2015].

    PubMed

    Rivera, Juan A; Martorell, Reynaldo; González, Wendy; Lutter, Chessa; Cossío, Teresa González de; Flores-Ayala, Rafael; Uauy, Ricardo; Delgado, Hernán

    2011-01-01

    To describe the regional master plan of nutrition to address maternal and child malnutrition in a 5- year period developed by the Nutrition Technical Group. The Nutrition Technical Group developed a situation analysis describing the main nutrition problems, policies and programs in Mesoamerica. The situation analysis and a literature review about effective interventions to address malnutrition were conducted to develop a nutrition master plan. The Nutrition Technical Group held various meetings to develop, discuss and validate the master plan. Theory of change identified problems and barriers, the actions to be developed, the changes and impacts expected. A package of interventions is proposed to reduce undernutrition and micronutrient deficiencies useful under different epidemiological contexts. The nutrition master plan provides a guideline of best practices that can be used for evidence-informed decision making and the development of national policies and programs to reduce malnutrition. PMID:22344375

  5. Programmatic response to malnutrition in India, room for more than one elephant.

    PubMed

    Dasgupta, Rajib; Sinha, Dipa; Yumnam, Veda

    2014-11-01

    Programming platforms need to recognize the diversity of malnutrition epidemiology in India and choose appropriate implementation designs. With severe chronic malnutrition as the dominant epidemiologic entity, the net needs to be cast wide, focusing on food security, health care, agriculture, water and sanitation, livelihoods and womens empowerment. Community-based malnutrition treatment and prevention programs need to collaborate to complement treatment with socioeconomic and preventive interventions. Expansion of nutrition rehabilitation centers should be limited to areas/districts with high wasting. Pediatric services with nested nutrition services (including counseling) requires urgent strengthening. Continuum of Care is a weak link and requires strengthening to make both hospital and community-based models meaningful. PMID:25432212

  6. Malnutrition in Joint Arthroplasty: Prospective Study Indicates Risk of Unplanned ICU Admission

    PubMed Central

    Kamath, Atul F.; McAuliffe, Caitlin L.; Kosseim, Laura M.; Pio, Finnah; Hume, Eric

    2016-01-01

    Background: Malnutrition has been linked to poor outcomes after elective joint arthroplasty, but the risk of unplanned postoperative intensive care unit (ICU) admission in malnourished arthroplasty patients is unknown. Methods: 1098 patients were followed as part of a prospective risk stratification program at a tertiary, high-volume arthroplasty center. Chronic malnutrition was defined as preoperative albumin <3.5 g/dL. Results: The overall incidence of malnutrition was 16.9% (primary and revision arthroplasty patients). Average BMI was highest for patients in albumin category 3.0-3.5 (BMI 35.7). Preoperative albumin <3.0 and <3.5 g/dL translated to 15.4% and 3.8% rates of unplanned ICU admission, respectively, indicating nutritional status to be a factor in postoperative ICU admission. Conclusion: Patients with poor nutritional status must be counseled on the risks of adverse medical complications. PMID:27200389

  7. [Decreased intraepithelial lymphocytes in the intestinal mucosa in children with malnutrition and parasitic infections].

    PubMed

    Gendrel, D; Richard-Lenoble, D; Kombila, M; Nardou, M; Gahouma, D; Barbet, J P; Walter, P

    1992-02-01

    In Gabon, 15 children aged 13 to 36 months admitted for malnutrition with chronic diarrhea underwent a small bowel biopsy for detection of parasites in the duodenal contents and histologic evaluation of the intestinal mucosa. In every case, intraepithelial lymphocyte counts (IELC) were under the lower limit of normal for children and adults, regardless of whether or not parasites were found. Partial villous atrophy was a consistent finding. Proportion of lymphocytes among intraepithelial cells was 7.4% in the 6 children with no parasitic infection, 7.9% in the children with giardiasis, and 8.1% in the children with strongyloidiasis. Appropriate treatment of the parasitic infections was quickly followed by resolution of the diarrhea in the nine patients with demonstrable intestinal parasites. These data should be compared with the well documented lymphocyte function anomalies associated with protein-calory malnutrition. The fall in IELC and lack of response to local anigenic stimulations are features of malnutrition. PMID:1580534

  8. Severe exfoliative erythema of malnutrition in a child with coexisting coeliac and Hartnup's disease.

    PubMed

    Sander, C S; Hertecant, J; Abdulrazzaq, Y M; Berger, T G

    2009-03-01

    Exfoliative erythema of malnutrition is a collective term for skin lesions caused by a combination of multiple deficiencies in vitamins, microelements, essential fatty acids and amino acids. We report a 3-year-old Iraqi girl with malnutrition due to coexisting coeliac and Hartnup's disease. On admission to hospital, she presented with kwashiorkor, anaemia, hepatitis and hypoalbuminia. She had severe skin changes with erythema, desquamation, erosions and diffuse hyperpigmentation involving the whole integument, particularly the perioral area, trunk and legs. She also had angular cheilitis, glossitis, conjunctivitis and diffuse alopecia. After treatment with a high-protein gluten-free diet and supplementation with vitamins and microelements there was a rapid improvement in the skin lesions. The severity of the skin lesions in this case can be explained by the coexistence of two metabolic diseases causing complex malnutrition. PMID:19018792

  9. Description and evaluation of a new four-mode version of the Modal Aerosol Module (MAM4) within version 5.3 of the Community Atmosphere Model

    NASA Astrophysics Data System (ADS)

    Liu, X.; Ma, P.-L.; Wang, H.; Tilmes, S.; Singh, B.; Easter, R. C.; Ghan, S. J.; Rasch, P. J.

    2016-02-01

    Atmospheric carbonaceous aerosols play an important role in the climate system by influencing the Earth's radiation budgets and modifying the cloud properties. Despite the importance, their representations in large-scale atmospheric models are still crude, which can influence model simulated burden, lifetime, physical, chemical and optical properties, and the climate forcing of carbonaceous aerosols. In this study, we improve the current three-mode version of the Modal Aerosol Module (MAM3) in the Community Atmosphere Model version 5 (CAM5) by introducing an additional primary carbon mode to explicitly account for the microphysical ageing of primary carbonaceous aerosols in the atmosphere. Compared to MAM3, the four-mode version of MAM (MAM4) significantly increases the column burdens of primary particulate organic matter (POM) and black carbon (BC) by up to 40 % in many remote regions, where in-cloud scavenging plays an important role in determining the aerosol concentrations. Differences in the column burdens for other types of aerosol (e.g., sulfate, secondary organic aerosols, mineral dust, sea salt) are less than 1 %. Evaluating the MAM4 simulation against in situ surface and aircraft observations, we find that MAM4 significantly improves the simulation of seasonal variation of near-surface BC concentrations in the polar regions, by increasing the BC concentrations in all seasons and particularly in cold seasons. However, it exacerbates the overestimation of modeled BC concentrations in the upper troposphere in the Pacific regions. The comparisons suggest that, to address the remaining model POM and BC biases, future improvements are required related to (1) in-cloud scavenging and vertical transport in convective clouds and (2) emissions of anthropogenic and biomass burning aerosols.

  10. Application of a score system to evaluate the risk of malnutrition in a multiple hospital setting

    PubMed Central

    2013-01-01

    Background An increased but unpredictable risk of malnutrition is associated with hospitalization, especially in children with chronic diseases. We investigated the applicability of Screening Tool for Risk of Impaired Nutritional Status and Growth (STRONGkids), an instrument proposed to estimate the risk of malnutrition in hospitalized children. We also evaluated the role of age and co-morbidities as risk for malnutrition. Methods The STRONGkids consists of 4 items providing a score that classifies a patient in low, moderate, high risk for malnutrition. A prospective observational multi-centre study was performed in 12 Italian hospitals. Children 1–18 years consecutively admitted and otherwise unselected were enrolled. Their STRONGkids score was obtained and compared with the actual nutritional status expressed as BMI and Height for Age SD-score. Results Of 144 children (75 males, mean age 6.5 ± 4.5 years), 52 (36%) had an underlying chronic disease. According to STRONGkids, 46 (32%) children were at low risk, 76 (53%) at moderate risk and 22 (15%) at high risk for malnutrition. The latter had significantly lower Height for Age values (mean SD value -1.07 ± 2.08; p = 0.008) and BMI values (mean SD-values -0.79 ± 2.09; p = 0.0021) in comparison to other groups. However, only 29 children were actually malnourished. Conclusions The STRONGkids is easy to administer. It is highly sensitive but not specific. It may be used as a very preliminary screening tool to be integrated with other clinical data in order to reliably predict the risk of malnutrition. PMID:24373709

  11. Determinants of Malnutrition and Post-operative Complications in Hospitalized Surgical Patients

    PubMed Central

    de Aquino, José Luiz Braga

    2014-01-01

    ABSTRACT The study aimed to determine the nutritional status (NS) of hospitalized surgical patients and investigate a possible association between NS and type of disease, type of surgery and post-operative complications. The gender, age, disease, surgery, complications, length of hospital stay, number of medications, laboratory test results, and energy intake of 388 hospitalized surgical patients were recorded. NS was determined by classical anthropometry. The inclusion criteria were: nutritional status assessment done within the first 24 hours of admission, age ≥20 years, and complete medical history. Univariate and multiple Cox's regression analyses were employed to determine which variables were possible risk factors of malnutrition and complications. Malnutrition was more common in males (p=0.017), individuals aged 70 to 79 years (p=0.000), and individuals with neoplasms and digestive tract diseases (p=0.000). Malnourished individuals had longer hospital stays (p=0.013) and required more medications (p=0.001). The risk of malnutrition was associated with age and disease. Individuals aged 70 years or more had a two-fold increased risk of malnutrition (p=0.014; RR=2.207; 95% CI 1.169-4.165); those with neoplasms (p=0.008; RR=14.950; 95% CI 2.011-111.151) and those having digestive tract diseases (p=0.009; RR=14.826; 95% CI 1.939-113.362) had a 14-fold increased risk of malnutrition. Complications prevailed in older individuals (p=0.016), individuals with longer hospital stays (p=0.007), and individuals who died (p=0.002). The risk of complications was associated with age and BMI. In the present study, the risk of malnutrition was associated with age and type of disease; old age and low BMI may increase complications. PMID:25395903

  12. Treatment and prevention of malnutrition in Latin America: focus on Chile and Bolivia.

    PubMed

    Weisstaub, Gerardo; Aguilar, Ana Maria; Uauy, Ricardo

    2014-06-01

    Seven million children under 5 years of age died worldwide in 2011, and one-third had malnutrition. Latin America and Caribbean countries stand out for the notable improvement of their health and nutrition situation, particularly in pregnant women and young children. Nutrition-sensitive interventions such as promoting food security, women's empowerment, social safety nets, clean water, and sanitation, among others, are critical for success. In Bolivia, the program Desnutrición Cero (Malnutrition Zero) was able to reduce mortality from severe malnutrition after 5 years from 25% to less than 5%, based on widespread implementation of the World Health Organization 10-steps protocol for hospitalized care and the application of community management. The Economic Commission for Latin America estimated the cost of malnutrition for Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, Panama, and the Dominican Republic as US $6,658 million. Approximately 1 million children have dropped out of school because of malnutrition, and as a result, malnourished children have 2 years less schooling, which brings social and economic losses not only to those affected but to society at large. National and international nutrition and food programs developed over the past 50 years have been implemented as integral components of broader strategies of primary healthcare and education, oriented toward preventing deaths and improving the quality of life of low-socioeconomic-status groups. Treating hundreds or thousands of affected children will not solve the global public health problem of malnutrition. Access to adequate amounts of quality foods represents a basic human right and is a necessary precondition for health. In turn, good nutrition and health are prerequisites for human, social, and economic development. PMID:25069292

  13. Some factors contributing to protein-energy malnutrition in the middle belt of Nigeria.

    PubMed

    Ighogboja, S I

    1992-10-01

    A number of risk factors leading to malnutrition were investigated among 400 mothers of malnourished children in the middle belt of Nigeria. Poverty, family instability, poor environmental sanitation, faulty weaning practices, illiteracy, ignorance, large family size and preventable infections are the main factors responsible for malnutrition. The strategies for intervention are in the area of health education emphasizing the importance of breastfeeding, family stability, responsible parenthood and small family sizes through culturally acceptable family planning methods. There is need to improve weaning methods through nutrition education, growth monitoring and food demonstration with community participation. Political will is needed to improve literacy status, farming methods and general living conditions. PMID:1473511

  14. Exploring the role of environmental enteropathy in malnutrition, infant development and oral vaccine response

    PubMed Central

    Gilmartin, Allissia A.; Petri, William A.

    2015-01-01

    Environmental enteropathy (EE) is a poorly defined state of intestinal inflammation without overt diarrhoea that occurs in individuals exposed over time to poor sanitation and hygiene. It is characterized pathologically by small intestine villous blunting and inflammation. In children from low-income countries, it is implicated as a cause of malnutrition, oral vaccine failure and impaired cognitive development. Here we review the search for non-invasive biomarkers to measure EE non-invasively, and assess the current evidence linking EE to malnutrition, vaccine failure and neurocognitive development. PMID:25964455

  15. Malnutrition Among Children Younger Than 5 Years-Old in Conflict Zones of Chiapas, Mexico

    PubMed Central

    Sánchez-Pérez, Héctor Javier; Hernán, Miguel A.; Ríos-González, Adriana; Arana-Cedeño, Marcos; Navarro, Albert; Ford, Douglas; Micek, Mark A.; Brentlinger, Paula

    2007-01-01

    We performed a cross-sectional, community-based survey, supplemented by interviews with community leaders in Chiapas, Mexico, to examine the prevalence and predictors of child malnutrition in regions affected by the Zapatista conflict. The prevalence rates of stunting, wasting, and underweight were 54.1%, 2.9%, and 20.3%, respectively, in 2666 children aged younger than 5 years. Stunting was associated with indigenous ethnicity, poverty, region of residence, and intracommunity division. The results indicate that malnutrition is a serious public health problem in the studied regions. PMID:17194868

  16. [Malnutrition in the elderly--a interdisciplinary problem for the dentist].

    PubMed

    Besimo, Christian E; Luzi, Christina; Seiler, Walter O

    2007-01-01

    Success in dental treatment and long-term care of elderly persons requires an interdisciplinary consideration of aging. Medical knowledge, which is far beyond specific dental expertise, is assumed. A typical example is that of malnutrition, which in spite of its high frequency in the elderly, has not yet been considered to be important in dentistry. Missing diagnosis and therapy of malnutrition lead to increasing morbidity and mortality. Clarifying the nutritional conditions of aging persons therefore should also become a part of dental diagnosis to guarantee early medical diagnosis and therapy as well as to avoid oral complications. PMID:17708426

  17. High rates of malnutrition in older adults receiving different levels of health care in Lleida, Catalonia: an assessment of contributory factors.

    PubMed

    Jürschik, Pilar; Torres, Joan; Solá, Román; Nuin, Carmen; Botigué, Teresa; Lavedán, Ana

    2010-10-01

    The aim of this study was to define the factors associated with the presence or risk of malnutrition in older adults (>65 years of age) attending health care centers in Lleida, Catalonia, using a cross-sectional study approach. Nutritional parameters assessed included the Mini Nutritional Assessment Scale, sociodemographic and psychosocial factors, functional and cognitive status, swallowing and oral problems, texture and route of administration of the diet, changes in dietary intake, and presence of digestive disorders. A total of 398 individuals (184 men) with an average age of 77 years were included in the assessment. Poor nutritional status was recorded in 58% of the individuals. Factors independently associated with unsatisfactory nutritional status included weight loss, functional dependence, cognitive impairment, loneliness, living without a partner, history of heart disease, lung disease, and the presence of acute vomiting. PMID:21104512

  18. Extending MAM5 Meta-Model and JaCalIV E Framework to Integrate Smart Devices from Real Environments

    PubMed Central

    2016-01-01

    This paper presents the extension of a meta-model (MAM5) and a framework based on the model (JaCalIVE) for developing intelligent virtual environments. The goal of this extension is to develop augmented mirror worlds that represent a real and virtual world coupled, so that the virtual world not only reflects the real one, but also complements it. A new component called a smart resource artifact, that enables modelling and developing devices to access the real physical world, and a human in the loop agent to place a human in the system have been included in the meta-model and framework. The proposed extension of MAM5 has been tested by simulating a light control system where agents can access both virtual and real sensor/actuators through the smart resources developed. The results show that the use of real environment interactive elements (smart resource artifacts) in agent-based simulations allows to minimize the error between simulated and real system. PMID:26926691

  19. Extending MAM5 Meta-Model and JaCalIV E Framework to Integrate Smart Devices from Real Environments.

    PubMed

    Rincon, J A; Poza-Lujan, Jose-Luis; Julian, V; Posadas-Yagüe, Juan-Luis; Carrascosa, C

    2016-01-01

    This paper presents the extension of a meta-model (MAM5) and a framework based on the model (JaCalIVE) for developing intelligent virtual environments. The goal of this extension is to develop augmented mirror worlds that represent a real and virtual world coupled, so that the virtual world not only reflects the real one, but also complements it. A new component called a smart resource artifact, that enables modelling and developing devices to access the real physical world, and a human in the loop agent to place a human in the system have been included in the meta-model and framework. The proposed extension of MAM5 has been tested by simulating a light control system where agents can access both virtual and real sensor/actuators through the smart resources developed. The results show that the use of real environment interactive elements (smart resource artifacts) in agent-based simulations allows to minimize the error between simulated and real system. PMID:26926691

  20. High Prevalence of Severe Food Insecurity and Malnutrition among HIV-Infected Adults in Senegal, West Africa

    PubMed Central

    Benzekri, Noelle A.; Sambou, Jacques; Diaw, Binetou; Sall, El Hadji Ibrahima; Sall, Fatima; Niang, Alassane; Ba, Selly; Ngom Guèye, Ndèye Fatou; Diallo, Mouhamadou Baïla; Hawes, Stephen E.; Seydi, Moussa; Gottlieb, Geoffrey S.

    2015-01-01

    Background Malnutrition and food insecurity are associated with increased mortality and poor clinical outcomes among people living with HIV/AIDS; however, the prevalence of malnutrition and food insecurity among people living with HIV/AIDS in Senegal, West Africa is unknown. The objective of this study was to determine the prevalence and severity of food insecurity and malnutrition among HIV-infected adults in Senegal, and to identify associations between food insecurity, malnutrition, and HIV outcomes. Methods We conducted a cross-sectional study at outpatient clinics in Dakar and Ziguinchor, Senegal. Data were collected using participant interviews, anthropometry, the Household Food Insecurity Access Scale, the Individual Dietary Diversity Scale, and chart review. Results One hundred and nine HIV-1 and/or HIV-2 participants were enrolled. The prevalence of food insecurity was 84.6% in Dakar and 89.5% in Ziguinchor. The prevalence of severe food insecurity was 59.6% in Dakar and 75.4% in Ziguinchor. The prevalence of malnutrition (BMI <18.5) was 19.2% in Dakar and 26.3% in Ziguinchor. Severe food insecurity was associated with missing clinic appointments (p = 0.01) and not taking antiretroviral therapy due to hunger (p = 0.02). Malnutrition was associated with lower CD4 cell counts (p = 0.01). Conclusions Severe food insecurity and malnutrition are highly prevalent among HIV-infected adults in both Dakar and Ziguinchor, and are associated with poor HIV outcomes. Our findings warrant further studies to determine the root causes of malnutrition and food insecurity in Senegal, and the short- and long-term impacts of malnutrition and food insecurity on HIV care. Urgent interventions are needed to address the unacceptably high rates of malnutrition and food insecurity in this population. PMID:26529509

  1. High Malnutrition Rate in Venezuelan Yanomami Compared to Warao Amerindians and Creoles: Significant Associations WITH Intestinal Parasites and Anemia

    PubMed Central

    Verhagen, Lilly M.; Incani, Renzo N.; Franco, Carolina R.; Ugarte, Alejandra; Cadenas, Yeneska; Sierra Ruiz, Carmen I.; Hermans, Peter W. M.; Hoek, Denise; Campos Ponce, Maiza; de Waard, Jacobus H.; Pinelli, Elena

    2013-01-01

    Background Children in rural areas experience the interrelated problems of poor growth, anemia and parasitic infections. We investigated the prevalence of and associations between intestinal helminth and protozoan infections, malnutrition and anemia in school-age Venezuelan children. Methods This cross-sectional study was conducted in 390 children aged 4-16 years from three rural areas of Venezuela: the Amazon Region, Orinoco Delta and Carabobo State. Stool samples were collected for direct parasitic examinations. Anthropometric indicators of chronic (height-for-age Z score) and acute (weight-for-height and Body Mass Index (BMI)-for-age Z score in respectively children under 5 years of age and children aged 5 years and above) malnutrition were calculated. Multivariate linear and logistic regression models were built to determine factors associated with nutritional status and polyparasitism. Results Hookworm and Strongyloides stercoralis prevalences were highest in children from the Amazon rainforest (respectively 72% and 18%) while children from the Orinoco Delta and Carabobo State showed higher rates of Ascaris lumbricoides (respectively 28% and 37%) and Trichuris trichiura (40% in both regions). The prevalence of Giardia lamblia infection was not significantly different between regions (average: 18%). Anemia prevalence was highest in the Amazon Region (24%). Hemoglobin levels were significantly decreased in children with a hookworm infection. Malnutrition was present in respectively 84%, 30% and 13% of children from the Amazon Region, Orinoco Delta and Carabobo State. In multivariate analysis including all regions, G. lamblia and helminth infections were significantly and negatively associated with respectively height-for-age and weight-for-height/BMI-for-age Z scores. Furthermore, hemoglobin levels were positively associated with the height-for-age Z score (0.11, 95% CI 0.02 - 0.20). Conclusions In rural populations in Venezuela helminthiasis and giardiasis were

  2. Impact of malnutrition on pediatric risk of mortality score and outcome in Pediatric Intensive Care Unit

    PubMed Central

    Nangalu, Romi; Pooni, Puneet Aulakh; Bhargav, Siddharth; Bains, Harmesh Singh

    2016-01-01

    Objectives: This study was done to determine the effect of malnutrition on mortality in Pediatric Intensive Care Unit (PICU) and on the pediatric risk of mortality (PRISM) scoring. Subjects and Methods: This was a prospective study done over 1 year. There were total 400 patients (1 month 14 years), who were divided into cases with weight for age <3rd centile and controls with ≥3rd centile of WHO charts. Cases were subdivided into mild/moderate (61–80% of expected weight for age) and severe malnutrition (<60%). Results: Out of total, 38.5% patients were underweight, and malnutrition was more in infancy, 61/104, i.e. 58.5% (P - 0.003). There was no significant difference in vitals at admission. Cases needed prolonged mechanical ventilation (P - 0.0063) and hospital stay (P - 0.0332) compared to controls. Mean and median PRISM scores were comparable in both the groups, but mortality was significantly higher in severely malnourished (P value 0.027). Conclusion: Severe malnutrition is independently associated with higher mortality even with similar PRISM score. There is need to give an additional score to children with weight for age <60% of expected. PMID:27555691

  3. [Considerations on family dynamics and the malnutrition syndrome in Mexican children].

    PubMed

    Vásquez-Garibay, Edgar Manuel; González-Rico, José Luis; Romero-Velarde, Enrique; Sánchez-Talamantes, Eva; Navarro-Lozano, María Eugenia; Nápoles-Rodríguez, Francisco

    2015-01-01

    Since the early 1990s we noted that family dysfunction was more common in children with severe primary malnutrition than in children admitted to the hospital without malnutrition. Defects on feeding habits during the first year of life, especially early weaning and inadequate complementary feeding were more common in dysfunctional families. We also observed that chronic malnutrition in preschool children, and overweight and obesity in schoolchildren were more common in children from dysfunctional families. Once the association between dysfunctional family dynamics and obesity in schoolchildren was demonstrated, it was observed that low education of fathers and mothers increased twofold the possibility of family dysfunction: OR: 2.06; 95% CI: 1.37-3.10 and OR: 2.47; 95% CI: 1.57-3.89, respectively. In addition, the low-income and the lower purchasing power of foods were associated to family dysfunction (p<0.05). A remaining task is to explore how to assess family dysfunction in composite, extended, single-parent families where there exist other persons vulnerable to the different entities of malnutrition syndrome and indeed depend on adults for their care, food and nutrition. PMID:26581537

  4. [Nutrition and malnutrition in the intensive coronary care unit. Fundamentals for the clinical cardiologist].

    PubMed

    Brogi, Daria; Espinosa, Emma; Lilli, Alessio; Bovenzi, Francesco Maria; Battino, Maurizio

    2016-04-01

    Patients admitted to coronary care units (CCU) have largely changed in the last decades. As observed in national and international registries, they are older, with different degrees of disability and several comorbidities. Moreover, they often undergo complex procedures. In this scenario, the cardiologist of the CCU has to deal with multidisciplinarity that should involve physiology and pathophysiology of nutrition. Despite the lack of specific data about our CCUs, hospital malnutrition is indeed a common entity that can reach a prevalence of 50% in elderly patients aged more than 75 years old. Malnutrition has several consequences in CCU patients since it involves respiratory drive, immune system and, clinically, patients have longer CCU stay and more complications. Briefly, malnutrition has a significant impact on their final outcome. In the clinical arena, the main issues for CCU physicians are the nutritional screening tools to promote an early recognition of patients with malnutrition, the pathophysiological knowledge of nutrition for a correct interaction with nutritionists, and the way of administration with its major complications. The changes in the population within CCUs are relatively recent and, although specific data in the cardiology setting are still scarce, nutrition science has reached a high level of knowledge to understand and plan tailored nutritional schemes based on the clinical and demographic features of our sick patients. PMID:27093209

  5. Impact of maternal malnutrition during the periconceptional period on mammalian preimplantation embryo development.

    PubMed

    Velazquez, M A

    2015-04-01

    During episodes of undernutrition and overnutrition the mammalian preimplantation embryo undergoes molecular and metabolic adaptations to cope with nutrient deficits or excesses. Maternal adaptations also take place to keep a nutritional microenvironment favorable for oocyte development and embryo formation. This maternal-embryo communication takes place via several nutritional mediators. Although adaptive responses to malnutrition by both the mother and the embryo may ensure blastocyst formation, the resultant quality of the embryo can be compromised, leading to early pregnancy failure. Still, studies have shown that, although early embryonic mortality can be induced during malnutrition, the preimplantation embryo possesses an enormous plasticity that allows it to implant and achieve a full-term pregnancy under nutritional stress, even in extreme cases of malnutrition. This developmental strategy, however, may come with a price, as shown by the adverse developmental programming induced by even subtle nutritional challenges exerted exclusively during folliculogenesis and the preimplantation period, resulting in offspring with a higher risk of developing deleterious phenotypes in adulthood. Overall, current evidence indicates that malnutrition during the periconceptional period can induce cellular and molecular alterations in preimplantation embryos with repercussions for fertility and postnatal health. PMID:25498236

  6. A new approach to defining and diagnosing malnutrition in adult critical illness

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This review will highlight a new approach to defining malnutrition syndromes for critically ill adults that incorporates a modern understanding of the contributions of inflammatory response. A systematic approach to nutrition assessment is described to help support diagnosis. Recent findings sugges...

  7. Malnutrition among under-five children in India and strategies for control

    PubMed Central

    Sahu, Swaroop Kumar; Kumar, S. Ganesh; Bhat, B. Vishnu; Premarajan, K. C.; Sarkar, Sonali; Roy, Gautam; Joseph, Nitin

    2015-01-01

    Malnutrition among under-five children is an important concern for the health authorities in India. The aim of the present review was to assess the burden of under-nutrition and over-nutrition, its determinants and strategies required to tackle malnutrition among under-five children in India. Recent data were collected from Google search, Medline, and others. The information retrieved was reviewed and analyzed for discrepancies. Existing evidence shows that the prevalence of under-nutrition among under-five children was high and varied widely (under-weight: 39-75%, stunting: 15.4-74%, wasting: 10.6-42.3%) depending on the assessment methodology adopted. Studies on assessment of over-nutrition status among under-five children were limited. Distribution of various types of risk factors and its influence on nutrition status of children in a given set up should be analyzed for planning the control measures. Strengthening public health interventions for mild malnutrition cases and vulnerable groups, effective implementation and evaluation of the strategies at regional level, research on overweight, obesity and its etiological factors and steps for improving socioeconomic development are the prerequisites for tackling malnutrition among under-five children in India. PMID:25810629

  8. Implementation of WHO guidelines on management of severe malnutrition in hospitals in Africa.

    PubMed Central

    Deen, Jacqueline L.; Funk, Matthias; Guevara, Victor C.; Saloojee, Haroon; Doe, James Y.; Palmer, Ayo; Weber, Martin W.

    2003-01-01

    OBJECTIVE: To investigate the problems, benefits, feasibility, and sustainability of implementation of WHO guidelines on management of severe malnutrition. METHODS: A postal survey invited staff from 12 African hospitals to participate in the study. Five hospitals were evaluated and two were selected to take part in the study: a district hospital in South Africa and a mission hospital in Ghana. At an initial visit, an experienced paediatrician reviewed the situation in the hospitals and introduced the principles of the guidelines through a participatory approach. During a second visit about six months later, the paediatrician reviewed the feasibility and sustainability of the introduced changes and helped find solutions to problems. At a final visit after one year, the paediatrician reassessed the overall situation. FINDINGS: Malnutrition management practices improved at both hospitals. Measures against hypoglycaemia, hypothermia, and infection were strengthened. Early, frequent feeding was established as a routine practice. Some micronutrients for inclusion in the diet were not locally available and needed to be imported. Problems were encountered with monitoring of weight gain and introducing a rehydration solution for malnutrition. CONCLUSION: Implementation of the main principles of the WHO guidelines on severe malnutrition was feasible, affordable, and sustainable at two African hospitals. The guidelines could be improved by including suggestions on how to adapt specific recommendations to local situations. The guidelines are well supported by experience and published reports, but more information is needed about some components and their impact on mortality. PMID:12764489

  9. Unique metabolic characteristics of the major syndromes of severe childhood malnutrition

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The major clinical syndromes of severe childhood malnutrition (SCM) are marasmus, kwashiorkor and marasmic-kwashiorkor. Whereas treatment of marasmus is straightforward and the associated mortality is low, kwashiorkor and marasmic-kwashiorkor are difficult to treat and have high morbidity and mortal...

  10. Scientific Study of Malnutrition as a Limiting Factor in the Development of Education.

    ERIC Educational Resources Information Center

    Picasso de Oyague, Alfredo

    This study on malnutrition as a limiting factor in the development of education (and, hence, in socioeconomic development generally) was presented to the UNESCO Seminar on Education, Nutrition, Agriculture and Man. The paper reports on recent research showing that the development of the central nervous system in very young children (including the…

  11. Malnutrition in the First Year of Life and Personality at Age 40

    ERIC Educational Resources Information Center

    Galler, Janina R.; Bryce, Cyralene P.; Zichlin, Miriam L.; Waber, Deborah P.; Exner, Natalie; Fitzmaurice, Garrett M.; Costa, Paul T.

    2013-01-01

    Background: Early childhood malnutrition is associated with cognitive and behavioral impairment during childhood and adolescence, but studies in adulthood are limited. Methods: Using the NEO-PI-R personality inventory, we compared personality profiles at 37-43 years of age ("M" 40.3 years, "SD" 1.9) of Barbadian adults who had…

  12. Malnutrition in China's Rural Boarding Schools: The Case of Primary Schools in Shaanxi Province

    ERIC Educational Resources Information Center

    Luo, Renfu; Shi, Yaojiang; Zhang, Linxiu; Liu, Chengfang; Rozelle, Scott; Sharbono, Brian

    2009-01-01

    The main goal of this paper is to document the nature of boarding schools and empirically analyse the difference in nutrition intake and malnutrition status between boarding and non-boarding students in western rural China. By using two data sets on boarding schools and boarding students in Shaanxi Province, a representative province in western…

  13. Malnutrition among under-five children in India and strategies for control.

    PubMed

    Sahu, Swaroop Kumar; Kumar, S Ganesh; Bhat, B Vishnu; Premarajan, K C; Sarkar, Sonali; Roy, Gautam; Joseph, Nitin

    2015-01-01

    Malnutrition among under-five children is an important concern for the health authorities in India. The aim of the present review was to assess the burden of under-nutrition and over-nutrition, its determinants and strategies required to tackle malnutrition among under-five children in India. Recent data were collected from Google search, Medline, and others. The information retrieved was reviewed and analyzed for discrepancies. Existing evidence shows that the prevalence of under-nutrition among under-five children was high and varied widely (under-weight: 39-75%, stunting: 15.4-74%, wasting: 10.6-42.3%) depending on the assessment methodology adopted. Studies on assessment of over-nutrition status among under-five children were limited. Distribution of various types of risk factors and its influence on nutrition status of children in a given set up should be analyzed for planning the control measures. Strengthening public health interventions for mild malnutrition cases and vulnerable groups, effective implementation and evaluation of the strategies at regional level, research on overweight, obesity and its etiological factors and steps for improving socioeconomic development are the prerequisites for tackling malnutrition among under-five children in India. PMID:25810629

  14. Growth assessment and risk factors of malnutrition in children with cystic fibrosis

    PubMed Central

    Isa, Hasan M.; Al-Ali, Lina F.; Mohamed, Afaf M.

    2016-01-01

    Objectives: To evaluate the nutritional status, to screen for the presence of malnutrition, and to study the possible risk factors associated with malnutrition in patients with cystic fibrosis (CF). Methods: A retrospective cross-sectional review of medical records of all diagnosed CF patients in the Pediatric Department, Salmaniya Medical Complex, Manama, Kingdom of Bahrain, between January 1984 and May 2015 was conducted. Demographic and anthropometric data were collected from records of last visit to CF clinic. Nutritional status and risk factors of malnutrition were assessed. Results: All records of 109 CF patients were reviewed. Forty-seven pediatric patients were included in the study. All included patients were on pancreatic enzyme replacement and 42 (89%) received high-calorie supplementation. Growth failure was noted in 34 (72%) patients, 19 (56%) were wasted and stunted, 8 (23.5%) were wasted only, and 7 (20.5%) were stunted. Low birth weight (p=0.032), and the presence of gastroesophageal reflux disease (GERD) (p=0.039) were the significant risk factors for malnutrition. Conclusion: Most CF patients in Bahrain (72%) are malnourished. Low birth weight and the presence of GERD are risk factors. PMID:26905352

  15. The Association between Parameters of Malnutrition and Diagnostic Measures of Sarcopenia in Geriatric Outpatients

    PubMed Central

    Reijnierse, Esmee M.; Trappenburg, Marijke C.; Leter, Morena J.; Blauw, Gerard Jan; de van der Schueren, Marian A. E.; Meskers, Carel G. M.; Maier, Andrea B.

    2015-01-01

    Objectives Diagnostic criteria for sarcopenia include measures of muscle mass, muscle strength and physical performance. Consensus on the definition of sarcopenia has not been reached yet. To improve insight into the most clinically valid definition of sarcopenia, this study aimed to compare the association between parameters of malnutrition, as a risk factor in sarcopenia, and diagnostic measures of sarcopenia in geriatric outpatients. Material and Methods This study is based on data from a cross-sectional study conducted in a geriatric outpatient clinic including 185 geriatric outpatients (mean age 82 years). Parameters of malnutrition included risk of malnutrition (assessed by the Short Nutritional Assessment Questionnaire), loss of appetite, unintentional weight loss and underweight (body mass index <22 kg/m2). Diagnostic measures of sarcopenia included relative muscle mass (lean mass and appendicular lean mass [ALM] as percentages), absolute muscle mass (total lean mass and ALM/height2), handgrip strength and walking speed. All diagnostic measures of sarcopenia were standardized. Associations between parameters of malnutrition (independent variables) and diagnostic measures of sarcopenia (dependent variables) were analysed using multivariate linear regression models adjusted for age, body mass, fat mass and height in separate models. Results None of the parameters of malnutrition was consistently associated with diagnostic measures of sarcopenia. The strongest associations were found for both relative and absolute muscle mass; less stronger associations were found for muscle strength and physical performance. Underweight (p = <0.001) and unintentional weight loss (p = 0.031) were most strongly associated with higher lean mass percentage after adjusting for age. Loss of appetite (p = 0.003) and underweight (p = 0.021) were most strongly associated with lower total lean mass after adjusting for age and fat mass. Conclusion Parameters of malnutrition relate

  16. 2-Methoxy-6-acetyl-7-methyljuglone (MAM), a natural naphthoquinone, induces NO-dependent apoptosis and necroptosis by H2O2-dependent JNK activation in cancer cells.

    PubMed

    Sun, Wen; Bao, Jiaolin; Lin, Wei; Gao, Hongwei; Zhao, Wenwen; Zhang, Qingwen; Leung, Chung-Hang; Ma, Dik-Lung; Lu, Jinjian; Chen, Xiuping

    2016-03-01

    Redox signaling plays a fundamental role in maintaining cell physiological activities. A deregulation of this balance through oxidative stress or nitrosative stress has been implicated in cancer. Here, we reported that 2-methoxy-6-acetyl-7-methyl juglone (MAM), a natural naphthoquinone isolated from Polygonum cuspidatum Sieb. et Zucc, caused hydrogen peroxide (H2O2) dependent activation of JNK and induced the expression of inducible nitric oxide synthase (iNOS), thereby leading to nitric oxide (NO) generation in multiple cancer cells. Nitrosative stress induced necroptosis in A549 lung cancer cells, but resulted in caspase-dependent intrinsic apoptosis in B16-F10 melanoma and MCF7 breast cancer cells. In addition, a decrease in GSH/GSSG levels accompanied with increased ROS production was observed. Reversal of ROS generation and cell death in GSH pretreated cells indicated the involvement of GSH depletion in MAM mediated cytotoxicity. In summary, a natural product MAM induced NO-dependent multiple forms of cell death in cancer cells mediated by H2O2-dependent JNK activation in cancer cells. GSH depletion might play an initial role in MAM-induced cytotoxicity. PMID:26802903

  17. Magnetite Biomineralization in Magnetospirillum magneticum Is Regulated by a Switch-like Behavior in the HtrA Protease MamE.

    PubMed

    Hershey, David M; Browne, Patrick J; Iavarone, Anthony T; Teyra, Joan; Lee, Eun H; Sidhu, Sachdev S; Komeili, Arash

    2016-08-19

    Magnetotactic bacteria are aquatic organisms that produce subcellular magnetic particles in order to orient in the earth's geomagnetic field. MamE, a predicted HtrA protease required to produce magnetite crystals in the magnetotactic bacterium Magnetospirillum magneticum AMB-1, was recently shown to promote the proteolytic processing of itself and two other biomineralization factors in vivo Here, we have analyzed the in vivo processing patterns of three proteolytic targets and used this information to reconstitute proteolysis with a purified form of MamE. MamE cleaves a custom peptide substrate with positive cooperativity, and its autoproteolysis can be stimulated with exogenous substrates or peptides that bind to either of its PDZ domains. A misregulated form of the protease that circumvents specific genetic requirements for proteolysis causes biomineralization defects, showing that proper regulation of its activity is required during magnetite biosynthesis in vivo Our results represent the first reconstitution of the proteolytic activity of MamE and show that its behavior is consistent with the previously proposed checkpoint model for biomineralization. PMID:27302060

  18. Child malnutrition and recurrent flooding in rural eastern India: a community-based survey

    PubMed Central

    Ranjan-Dash, Shisir; Degomme, Olivier; Mukhopadhyay, Alok; Guha-Sapir, Debarati

    2011-01-01

    Objectives This study aims to improve the understanding of the relationship between exposure to floods and malnutrition in children aged 6–59 months in rural India. Research has focused exclusively on Bangladeshi children, and few controlled epidemiological studies are available. Method A community-based cross-sectional study of child nutritional status was carried out in 14 flooded and 18 non-flooded villages of Jagatsinghpur district (Orissa) within one month of the September 2008 floods, and similarly affected by flooding in August 2006. Face-to-face interviews were conducted in 757 households in the flooded villages and 816 in the non-flooded communities. Data used in this study were from those households with children aged 6–59 months. In total, 191 and 161 children were measured, respectively. The association between various malnutrition indicators and the exposure to floods was assessed by univariate and multivariate logistic regression. Results Adjusted analyses revealed that children in flooded households were more likely stunted compared with those in non-flooded ones (adjusted prevalence ratio 1.60; 95% CI 1.05 to 2.44). The prevalence of underweight was also higher in children living in the flooded communities (adjusted prevalence ratio 1.86; 95% CI 1.04 to 3.30). Further analyses found that the 26–36-month flooded cohort, thus those children younger than 1 year during the precedent flood in August 2006, attained the largest difference in levels of stunting compared with the unexposed group of the same age. Conclusion Exposure to floods is associated with long-term malnutrition in these rural communities of Orissa, India. Children exposed to floods during their first year of life presented higher levels of chronic malnutrition. Long-term malnutrition prevention programmes after floods should be implemented in flood-prone areas. PMID:22080535

  19. Magnitude and determinants of malnutrition among pregnant women in eastern Ethiopia: evidence from rural, community-based setting.

    PubMed

    Kedir, Haji; Berhane, Yemane; Worku, Alemayehu

    2016-01-01

    Maternal malnutrition is a worldwide public health problem affecting a high proportion of pregnant women. This study aimed to determine the magnitude and determinants of malnutrition among pregnant women in eastern Ethiopia. A cross-sectional study was conducted on 1731 pregnant women selected by a cluster random sampling method. Data on maternal anthropometry and other factors were gathered by trained data collectors. Mid-upper arm circumference < 22 cm defined malnutrition. Mixed-effect, multilevel logistic regression was used to control clustering effect. On average, 19.06% of subjects were malnourished, while 23.3% study participants were underweight (body mass index < 19.8 kg m(-2)). In the final adjusted analysis, the risk of malnutrition was more than twofold higher in pregnant women with low (adjusted odds ratio = 2.47, 95% confidence interval = 1.41-4.34) and medium (adjusted odds ratio = 2.74, 95% confidence interval = 1.40-5.35) autonomy of household decision-making than those who had high level of autonomy in household decision-making. Husband illiteracy and not owning livestock were associated with increased risk of malnutrition. Women in the second and third trimester had a 66% and nearly twofold increased risk of malnutrition compared with their counterparts in the first trimester, respectively. Women who improved their eating habits had a 53% lower risk of malnutrition than those who did not. The risk of malnutrition was 39% lower in respondents who received prenatal dietary advice than in those who did not. Malnutrition affects at least one of every five pregnant women studied, calling for priority attention. Interventions that improve maternal involvement in household decision-making autonomy and provision of prenatal dietary advice are recommended. PMID:24985910

  20. Cyclic MAM synthesis of SPION/BaMoO4:Er3+,Yb3+ composite and its optical properties

    NASA Astrophysics Data System (ADS)

    Lim, C. S.; Atuchin, V. V.

    2013-05-01

    Er3+/Yb3+ co-doped BaMoO4 (BaMoO4:Er3+/Yb3+) composites with superparamagnetic iron oxide nanoparticles (SPIONs) incorporated were successfully synthesized by a cyclic microwave-assisted metathetic (MAM) method followed by heat-treatment. The microstructure exhibited well-defined and homogeneous morphology with the BaMoO4:Er3+/Yb3+ particle size of 1-2 μm and Fe3O4 particle size of 0.1-0.5 μm. The Fe3O4 particles were self-preferentially crystallized and immobilized on the surface of BaMoO4:Er3+/Yb3+ particles. The synthesized SPION/BaMoO4:Er3+,Yb3+ composites were characterized by X-ray diffraction, scanning electron microscopy and energy-dispersive X-ray spectroscopy. Optical properties were examined using photoluminescence emission measurements and Raman spectroscopy.

  1. Effect of Short-Term Supplementation with Ready-to-Use Therapeutic Food or Micronutrients for Children after Illness for Prevention of Malnutrition: A Randomised Controlled Trial in Nigeria

    PubMed Central

    van der Kam, Saskia; Salse-Ubach, Nuria; Roll, Stephanie; Swarthout, Todd; Gayton-Toyoshima, Sayaka; Jiya, Nma Mohammed; Matsumoto, Akiko; Shanks, Leslie

    2016-01-01

    follow-up, 54 (2.4%) were admitted to hospital, and 29 (1.3%) died. The incidence rates of NNO for the RUTF, MNP, and control groups were 0.522 (95% confidence interval (95% CI), 0.442–0.617), 0.495 (0.415–0.589), and 0.566 (0.479–0.668) first events/y, respectively. The incidence rate ratio was 0.92 (95% CI, 0.74–1.15; p = 0.471) for RUTF versus control; 0.87 (0.70–1.10; p = 0.242) for MNP versus control and 1.06 (0.84–1.33, p = 0.642) for RUTF versus MNP. A subgroup analysis showed no interaction nor confounding, nor a different effectiveness of supplementation, among children who were moderately malnourished compared with non-malnourished at enrollment. The average number of study illnesses for the RUTF, MNP, and control groups were 4.2 (95% CI, 4.0–4.3), 3.4 (3.2–3.6), and 3.6 (3.4–3.7). The proportion of children who died in the RUTF, MNP, and control groups were 0.8% (95% CI, 0.3–1.8), 1.8% (1.0–3.3), and 1.4% (0.7–2.8). Conclusions A 2-wk supplementation with RUTF or MNP to ill children as part of routine primary medical care did not reduce the incidence of malnutrition. The lack of effect in Goronyo may be due to a high frequency of morbidity, which probably further affects a child’s nutritional status and children’s ability to escape from the illness–malnutrition cycle. The duration of the supplementation may have been too short or the doses of the supplements may have been too low to mitigate the effects of high morbidity and pre-existing malnutrition. An integrated approach combining prevention and treatment of diseases and treatment of moderate malnutrition, rather than prevention of malnutrition by nutritional supplementation alone, might be more effective in reducing the incidence of acute malnutrition in ill children. Trial Registration clinicaltrials.gov NCT01154803 PMID:26859559

  2. Acute Bronchitis

    MedlinePlus

    Bronchitis is an inflammation of the bronchial tubes, the airways that carry air to your lungs. It ... chest tightness. There are two main types of bronchitis: acute and chronic. Most cases of acute bronchitis ...

  3. [Management of malnutrition in preschool children: the role of primary health care services].

    PubMed

    Hoerée, Tom; Kolsteren, Patrick; Roberfroid, Dominique

    2002-01-01

    Although the prevalence of malnutrition in developing countries is decreasing, it is still a major problem for many children under five. As socio-economic conditions are the main determinants, a final solution for this problem can only be envisaged in the long run. Still, short-term strategies need to be defined in order to relieve the sufferings of individual children and their families. Understanding the problem and consequently formulating intervention programs at the local level remains a complex and difficult issue. The first reason being that the process of malnutrition expresses itself in different forms and with variable consequences. A second reason making malnutrition a complex problem is that the primary causes -- the interaction between insufficient food supply and the frequent recurrence of infectious diseases -- are determined by a multitude of factors of different natures. This complexity -- of its expressions, effects, and causality -- makes it difficult to get a global vision and understanding of the problem, which clearly impedes the definition of rational and integrated intervention strategies. Nevertheless, a better understanding of the pathophysiology of malnutrition and of the factors that influence the growth process in preschool age, will help to better direct actions. To this effect, a conceptual model will be built, based on recent insight in the process of malnutrition within this age group. From this model, two lines of action for increasing the chances of preschool children to express their initial growth potential, become apparent. A first series of activities could tackle the process that, via wasting and recurrence of infections, leads to an increased mortality risk. As timely intervention reduces the risk of depletion of energy reserves, these activities would also have an indirect impact on physical development. Elaborating strategies for secondary prevention and for treating severe cases belongs to the specific competence of the

  4. Effects of Malnutrition on Left Ventricular Mass in a North-Malagasy Children Population

    PubMed Central

    Di Gioia, Giuseppe; Creta, Antonio; Fittipaldi, Mario; Giorgino, Riccardo; Quintarelli, Fabio; Satriano, Umberto; Cruciani, Alessandro; Antinolfi, Vincenzo; Di Berardino, Stefano; Costanzo, Davide; Bettini, Ranieri; Mangiameli, Giuseppe; Caricato, Marco; Mottini, Giovanni

    2016-01-01

    Background Malnutrition among children population of less developed countries is a major health problem. Inadequate food intake and infectious diseases are combined to increase further the prevalence. Malnourishment brings to muscle cells loss with development of cardiac complications, like arrhythmias, cardiomyopathy and sudden death. In developed countries, malnutrition has generally a different etiology, like chronic diseases. The aim of our study was to investigate the correlation between malnutrition and left ventricular mass in an African children population. Methods 313 children were studied, in the region of Antsiranana, Madagascar, with age ranging from 4 to 16 years old (mean 7,8 ± 3 years). A clinical and echocardiographic evaluation was performed with annotation of anthropometric and left ventricle parameters. Malnutrition was defined as a body mass index (BMI) value age- and sex-specific of 16, 17 and 18,5 at the age of 18, or under the 15th percentile. Left ventricle mass was indexed by height2.7 (LVMI). Results We identified a very high prevalence of children malnutrition: 124 children, according to BMI values, and 100 children under the 15th percentile. LVMI values have shown to be increased in proportion to BMI percentiles ranging from 29,8 ± 10,8 g/m2.7 in the malnutrition group to 45 ± 15,1 g/m2.7 in >95th percentile group. LVMI values in children < 15th BMI percentile were significantly lower compared to normal nutritional status (29,8 ± 10,8 g/m2,7 vs. 32,9 ± 12,1 g/m2,7, p = 0.02). Also with BMI values evaluation, malnourished children showed statistically lower values of LVMI (29,3 ± 10,1 g/m2,7 vs. 33,6 ± 12,5 g/m2,7, p = 0.001). Conclusion In African children population, the malnourishment status is correlated with cardiac muscle mass decrease, which appears to be reduced in proportion to the decrease in body size. PMID:27140179

  5. Malnutrition and Childhood Disability in Turkana, Kenya: Results from a Case-Control Study

    PubMed Central

    Evans, Jennifer; Munyendo, David; Zuurmond, Maria; Frison, Severine; Mwenda, Victoria; Otieno, David; Kisia, James

    2015-01-01

    Background Children with disabilities may be particularly vulnerable to malnutrition, as a result of exclusions and feeding difficulties. However, there is limited evidence currently available on this subject. Methods A population-based case-control study was conducted in Turkana County, Kenya, between July and August 2013. Key informants in the community identified children aged 6 months to 10 years who they believed may have a disability. These children were screened by a questionnaire (UNICEF-Washington Group) and assessed by a paediatrician to confirm whether they had a disability and the type. Two controls without disabilities were selected per case: A sibling control (sibling nearest in age) and a neighbourhood control (nearest neighbour within one year of age). The caregiver completed a questionnaire on behalf of the child (e.g. information on feeding, poverty, illness, education), and anthropometric measures were taken. We undertook multivariable logistic and linear regression analyses to estimate the relationship between disability and malnutrition. Results The study included 311 cases with disabilities, 196 sibling controls and 300 neighbour controls. Children with disabilities were more likely to report a range of feeding difficulties. They were 1.6–2.9 times more likely to have malnutrition in comparison to neighbour controls or family controls, including general malnutrition (low weight for age), stunting (low height for age), low body mass index (BMI) or low mid upper arm circumference (MUAC) for age. Children with disabilities were almost twice as likely to have wasting (low weight for height) in comparison to neighbour controls (OR = 1.9, 95% CI 1.1–3.2), but this difference was not apparent compared with siblings (OR = 1.5, 95% CI 0.8–2.7). Children with disabilities also faced other exclusions. For instance those aged 5+ were much more likely not to attend school than neighbour controls (OR = 8.5, 95% CI 4.3–16.9). Conclusions Children

  6. A case-control study of maternal knowledge of malnutrition and health-care-seeking attitudes in rural South India.

    PubMed Central

    Saito, K.; Korzenik, J. R.; Jekel, J. F.; Bhattacharji, S.

    1997-01-01

    INTRODUCTION: In India, approximately 20 percent of children under the age of four suffer from severe malnutrition, while half of all the children suffer from undernutrition. The contributions of knowledge and attitudes of nutrition-conscious behaviors of the mothers to childhood malnutrition has been unclear. The purpose of this study was to explore maternal knowledge of the causes of malnutrition, health-care-seeking attitudes and socioeconomic risk factors in relation to children's nutritional status in rural south India. METHODS: A case-controlled study was conducted in a rural area in Tamil Nadu, India. Thirty-four cases and 34 controls were selected from the population of approximately 97,000 by using the local hospital's list of young children. A case was defined as a mother of a severely malnourished child under four years of age. Severe malnutrition was defined as having less than 60 percent of expected median weight-for-age. A control had a well-nourished child and was matched by the location and the age of the child. Interviews obtained: (1) socioeconomic information on the family, (2) knowledge of the cause of malnutrition and (3) health-care-seeking attitudes for common childhood illnesses, including malnutrition. RESULTS: Poor nutritional status was associated with socioeconomic variables such as sex of the child and father's occupation. Female gender (OR = 3.44, p = .02) and father's occupation as a laborer (OR = 2.98, p = .05) were significant risk factors for severe malnutrition. The two groups showed a significant difference in nutrition-related knowledge of mild mixed malnutrition (OR = 2.62, p = .05). No significant difference was apparent in health-care-seeking attitudes. Based on their traditional beliefs, the mothers did not believe that medical care was an appropriate intervention for childhood illnesses such as malnutrition or measles. DISCUSSION: The results suggested that the gender of the child and socioeconomic factors were stronger

  7. PERINATAL MALNUTRITION AND THE PROTECTIVE ROLE OF THE PHYSICAL TRAINING ON THE IMMUNE SYSTEM.

    PubMed

    Moreno Senna, Sueli; Ferraz, José Cândido; Leandro, Carol Góis

    2015-01-01

    Developing organisms have the ability to cope with environmental demands through physiologic and morphologic adaptations. Early life malnutrition has been recognized as an environmental stimulus that is related with down-regulation of immune responses. Some of these effects are explained by the epigenetics and the programming of hormones and cytokines impairing the modulation of the immune cells in response to environmental stimuli. Recently, it has been demonstrated that these effects are not deterministic and current environment, such as physical activity, can positively influence the immune system. Here, we discuss the effects of perinatal malnutrition on the immune system and how it can be modulated by physical training. The mechanism includes the normalization of some hormones concentrations related to growth and metabolism such as leptin, IGF-1 and glucocorticoids. PMID:26319808

  8. A qualitative study of risk factors related to child malnutrition in Aileu District, Timor-Leste.

    PubMed

    Mizumoto, Kaori; Takahashi, Toru; Kinoshita, Yuri; Higuchi, Michiyo; Bachroen, Cholis; Da Silva, Valente

    2015-03-01

    Improvement in child nutritional status is one of the major health priorities in Timor-Leste. A qualitative study was conducted in Aileu District, adjacent to the capital of Timor-Leste, Dili, in September 2010 to determine the possible risk factors associated with the high prevalence of child malnutrition. In-depth interviews were conducted to 32 guardians of children aged younger than 5 years. It was observed that early termination of exclusive breast-feeding and a short lactation period along with an unsanitary living environment were associated with the nutritional status of children in the study area. Although previous surveys have reported poor food security conditions in the country, no statements from the subjects supported this contention. The identified possible risk factors for child malnutrition were closely linked to each other and were mostly modifiable. PMID:23674826

  9. The double burden of malnutrition in SE Asia and the Pacific: priorities, policies and politics.

    PubMed

    Haddad, Lawrence; Cameron, Lisa; Barnett, Inka

    2015-11-01

    The double burden of malnutrition is defined by the co-existence of serious levels of under- and overnutrition.(1) Nowhere have overweight rates risen as fast as in the regions of South East Asia and the Pacific. The regions are also burdened with high and often stagnant levels of undernutrition. For countries for which data are available, the regions contain nearly half of the individuals, world wide, suffering from a double burden of malnutrition. This article reviews the trends and their consequences and for nine countries in these two regions it reviews the drivers of the problem and attempts to manage it. The article concludes with an analysis of the political challenges and opportunities presented by the double burden and some suggestions for a leadership agenda within the region to address it. PMID:25324529

  10. Malnutrition in the Critically Ill Child: The Importance of Enteral Nutrition

    PubMed Central

    Prieto, Marta Botrán; Cid, Jesús López-Herce

    2011-01-01

    Malnutrition affects 50% of hospitalized children and 25–70% of the critically ill children. It increases the incidence of complications and mortality. Malnutrition is associated with an altered metabolism of certain substrates, increased metabolism and catabolism depending on the severity of the lesion, and reduced nutrient delivery. The objective should be to administer individualized nutrition to the critically ill child and to be able to adjust the nutrition continuously according to the metabolic changes and evolving nutritional status. It would appear reasonable to start enteral nutrition within the first 24 to 48 hours after admission, when oral feeding is not possible. Parenteral nutrition should only be used when enteral nutrition is contraindicated or is not tolerated. Energy delivery must be individually adjusted to energy expenditure (40–65 kcal/100 calories metabolized/day) with a protein delivery of 2.5–3 g/kg/day. Frequent monitoring of nutritional and metabolic parameters should be performed. PMID:22163211

  11. Impact of foods nutritionally enhanced through biotechnology in alleviating malnutrition in developing countries.

    PubMed

    Gilani, G Sarwar; Nasim, Anwar

    2007-01-01

    According to United Nations (UN) projections, the world's population will grow from 6.1 billion in 2000 to 8 billion in 2025 and 9.4 billion in 2050. Most (93%) of the increase will take place in developing countries. The rapid population growth in developing countries creates major challenges for governments regarding food and nutrition security. According to current World Health Organization estimates, more than 3 billion people worldwide, especially in developing countries, are malnourished in essential nutrients. Malnutrition imposes severe costs on a country's population due to impaired physical and cognitive abilities and reduced ability to work. Little progress has been made in improving malnutrition over the past few decades. The Food and Agriculture Organization of the UN would like to see more nutrient-rich foods introduced into these countries, because supplements are expensive and difficult to distribute widely. Biofortification of staple crops through modern biotechnology can potentially help in alleviating malnutrition in developing countries. Several genetically modified crops, including rice, potatoes, oilseeds, and cassava, with elevated levels of essential nutrients (such as vitamin A, iron, zinc, protein and essential amino acids, and essential fatty acids); reduced levels of antinutritional factors (such as cyanogens, phytates, and glycoalkaloid); and increased levels of factors that influence bioavailability and utilization of essential nutrients (such as cysteine residues) are advancing through field trial stage and regulatory processes towards commercialization. The ready availability and consumption of the biofortified crops would have a significant impact in reducing malnutrition and the risk of chronic disease in developing countries. PMID:17955991

  12. Intake of Dietary Supplements and Malnutrition in Patients in Intensive Care Unit

    PubMed Central

    Samadi, Mehnoosh; Zeinali, Fahime; Habibi, Nahal; Ghotbodin-Mohammadi, Shirin

    2016-01-01

    Background: Malnutrition is prevalent among patients hospitalized in Intensive Care Units (ICUs) and causes various complications. Dietary supplementation to provide appropriate nutritional support may reduce the malnutrition and complications through improvement in nutritional status. This study was carried out to assess the association between dietary supplementation and malnutrition among patients in ICUs. Methods: A case–control study was conducted on 180 male patients aged 20–60 years in the ICUs of the hospitals in Ahvaz, Iran in 2013. Data of two groups including 83 patients (cases) who had consumed regular hospital meals and dietary supplements and 97 patients (controls) who had received regular hospital meals were compared. Anthropometric measurements, laboratory values, and dietary intakes were extracted from medical records, and Maastricht index (MI) was calculated. Data were analyzed using the IBM SPSS Statistics 21. T-test and paired-sample t-test were used to determine the difference between groups. Results: Taking supplements increased daily energy intake, carbohydrate, and protein in case group (n = 83) significantly (P < 0.05). MI changed to 3.1 ± 3.8 and 4.3 ± 4.2 in case (n = 83) and control (n = 97) groups, respectively. Although the MI fell in both groups, it showed a greater reduction in case group (from 6.3 ± 5.3 to 3.1 ± 3.8). Conclusions: Since consuming dietary supplements besides the regular hospital meals increased intake of energy and macronutrients and reduced the MI significantly, it was concluded that it helped supply nutritional requirements more effectively and improved the malnutrition in ICU. PMID:27512556

  13. Malnutrition in Hospitalized Pediatric Patients: Assessment, Prevalence, and Association to Adverse Outcomes.

    PubMed

    Daskalou, Efstratia; Galli-Tsinopoulou, Assimina; Karagiozoglou-Lampoudi, Thomais; Augoustides-Savvopoulou, Persefone

    2016-01-01

    Malnutrition is a frequent finding in pediatric health care settings in the form of undernutrition or excess body weight. Its increasing prevalence and impact on overall health status, which is reflected in the adverse outcomes, renders imperative the application of commonly accepted and evidence-based practices and tools by health care providers. Nutrition risk screening on admission and nutrition status evaluation are key points during clinical management of hospitalized pediatric patients, in order to prevent health deterioration that can lead to serious complications and growth consequences. In addition, anthropometric data based on commonly accepted universal growth standards can give accurate results for nutrition status. Both nutrition risk screening and nutrition status assessment are techniques that should be routinely implemented, based on commonly accepted growth standards and methodology, and linked to clinical outcomes. The aim of the present review was to address the issue of hospital malnutrition in pediatric settings in terms of prevalence, outline nutrition status evaluation and nutrition screening process using different criteria and available tools, and present its relationship with outcome measures. Key teaching points • Malnutrition-underweight or excess body weight-is a frequent imbalance in pediatric settings that affects physical growth and results in undesirable clinical outcomes. • Anthropometry interpretation through growth charts and nutrition screening are cornerstones for the assessment of malnutrition.To date no commonly accepted anthropometric criteria or nutrition screening tools are used in hospitalized pediatric patients. • Commonly accepted nutrition status and screening processes based on the World Health Organization's growth standards can contribute to the overall hospital nutrition care of pediatric patients. PMID:26709552

  14. Milk with and without lactoferrin can influence intestinal damage in a pig model of malnutrition.

    PubMed

    Garas, Lydia C; Feltrin, Cristiano; Hamilton, M Kristina; Hagey, Jill V; Murray, James D; Bertolini, Luciana R; Bertolini, Marcelo; Raybould, Helen E; Maga, Elizabeth A

    2016-02-01

    Malnutrition remains a leading contributor to the morbidity and mortality of children under the age of five worldwide. However, the underlying mechanisms are not well understood necessitating an appropriate animal model to answer fundamental questions and conduct translational research into optimal interventions. One potential intervention is milk from livestock that more closely mimics human milk by increased levels of bioactive components that can promote a healthy intestinal epithelium. We tested the ability of cow milk and milk from transgenic cows expressing human lactoferrin at levels found in human milk (hLF milk) to mitigate the effects of malnutrition at the level of the intestine in a pig model of malnutrition. Weaned pigs (3 weeks old) were fed a protein and calorie restricted diet for five weeks, receiving cow, hLF or no milk supplementation daily from weeks 3-5. After three weeks, the restricted diet induced changes in growth, blood chemistry and intestinal structure including villous atrophy, increased ex vivo permeability and decreased expression of tight junction proteins. Addition of both cow and hLF milk to the diet increased growth rate and calcium and glucose levels while promoting growth of the intestinal epithelium. In the jejunum hLF milk restored intestinal morphology, reduced permeability and increased expression of anti-inflammatory IL-10. Overall, this pig model of malnutrition mimics salient aspects of the human condition and demonstrates that cow milk can stimulate the repair of damage to the intestinal epithelium caused by protein and calorie restriction with hLF milk improving this recovery to a greater extent. PMID:26751615

  15. Malnutrition in Healthy Individuals Results in Increased Mixed Cytokine Profiles, Altered Neutrophil Subsets and Function.

    PubMed

    Takele, Y; Adem, E; Getahun, M; Tajebe, F; Kiflie, A; Hailu, A; Raynes, J; Mengesha, B; Ayele, T A; Shkedy, Z; Lemma, M; Diro, E; Toulza, F; Modolell, M; Munder, M; Müller, I; Kropf, P

    2016-01-01

    Malnutrition is commonly associated with increased infectious disease susceptibility and severity. Whereas malnutrition might enhance the incidence of disease as well as its severity, active infection can in turn exacerbate malnutrition. Therefore, in a malnourished individual suffering from a severe infection, it is not possible to determine the contribution of the pre-existing malnutrition and/or the infection itself to increased disease severity. In the current study we focussed on two groups of malnourished, but otherwise healthy individuals: moderately malnourished (BMI: 18.4-16.5) and severely malnourished (BMI <16.5) and compared several immune parameters with those of individuals with a normal BMI (≥18.5). Our results show a similar haematological profile in all three groups, as well as a similar ratio of CD4+ and CD8+ T cells. We found significant correlations between low BMI and increased levels of T helper (Th) 1 (Interferon (IFN)-γ, (interleukin (IL)-2, IL-12), Th2 (IL-4, IL-5, IL-13), as well as IL-10, IL-33 and tumor necrosis factor-α, but not IL-8 or C reactive protein. The activities of arginase, an enzyme associated with immunosuppression, were similar in plasma, peripheral blood mononuclear cells (PBMC) and neutrophils from all groups and no differences in the expression levels of CD3ζ, a marker of T cell activation, were observed in CD4+ and CD8+T cells. Furthermore, whereas the capacity of neutrophils from the malnourished groups to phagocytose particles was not impaired, their capacity to produce reactive oxygen species was impaired. Finally we evaluated the frequency of a subpopulation of low-density neutrophils and show that they are significantly increased in the malnourished individuals. These differences were more pronounced in the severely malnourished group. In summary, our results show that even in the absence of apparent infections, healthy malnourished individuals display dysfunctional immune responses that might contribute to

  16. Malnutrition in Healthy Individuals Results in Increased Mixed Cytokine Profiles, Altered Neutrophil Subsets and Function

    PubMed Central

    Takele, Y.; Adem, E.; Getahun, M.; Tajebe, F.; Kiflie, A.; Hailu, A.; Raynes, J.; Mengesha, B.; Ayele, T. A.; Shkedy, Z.; Lemma, M.; Diro, E.; Toulza, F.; Modolell, M.; Munder, M.; Müller, I.; Kropf, P.

    2016-01-01

    Malnutrition is commonly associated with increased infectious disease susceptibility and severity. Whereas malnutrition might enhance the incidence of disease as well as its severity, active infection can in turn exacerbate malnutrition. Therefore, in a malnourished individual suffering from a severe infection, it is not possible to determine the contribution of the pre-existing malnutrition and/or the infection itself to increased disease severity. In the current study we focussed on two groups of malnourished, but otherwise healthy individuals: moderately malnourished (BMI: 18.4–16.5) and severely malnourished (BMI <16.5) and compared several immune parameters with those of individuals with a normal BMI (≥18.5). Our results show a similar haematological profile in all three groups, as well as a similar ratio of CD4+ and CD8+ T cells. We found significant correlations between low BMI and increased levels of T helper (Th) 1 (Interferon (IFN)-γ, (interleukin (IL)-2, IL-12), Th2 (IL-4, IL-5, IL-13), as well as IL-10, IL-33 and tumor necrosis factor-α, but not IL-8 or C reactive protein. The activities of arginase, an enzyme associated with immunosuppression, were similar in plasma, peripheral blood mononuclear cells (PBMC) and neutrophils from all groups and no differences in the expression levels of CD3ζ, a marker of T cell activation, were observed in CD4+ and CD8+T cells. Furthermore, whereas the capacity of neutrophils from the malnourished groups to phagocytose particles was not impaired, their capacity to produce reactive oxygen species was impaired. Finally we evaluated the frequency of a subpopulation of low-density neutrophils and show that they are significantly increased in the malnourished individuals. These differences were more pronounced in the severely malnourished group. In summary, our results show that even in the absence of apparent infections, healthy malnourished individuals display dysfunctional immune responses that might contribute to

  17. The association between malnutrition and psychological distress in patients with advanced head-and-neck cancer

    PubMed Central

    Ma, L.; Poulin, P.; Feldstain, A.; Chasen, M.R.

    2013-01-01

    Objective Malnutrition and psychological distress are often seen in patients with head-and-neck cancer, but little is known about the interrelationships between those two symptoms. The present study examined the relationship between malnutrition and psychological distress in patients with advanced head-and-neck cancer. Methods Using the Patient-Generated Subjective Global Assessment, 99 patients with advanced-stage head-and-neck cancer were screened for nutrition status. The patients were also screened for psychosocial distress (using the Distress Thermometer) and for psychosocial issues (using the Problem Checklist). Any relationship between malnutrition and psychosocial distress was determined by regression and correlation analysis. We also used t-tests to compare distress levels for patients with and without specific nutrition-related symptoms. Results The study group included 80 men and 19 women [mean age: 58.4 ± 10.9 years (range: 23–85 years)]. The correlation between poorer nutrition status and level of psychological distress was significant r = 0.37 (p < 0.001). Specifically, reduced food intake and symptoms were both positively associated with distress: r = 0.27 and r = 0.29 respectively, both significant at p < 0.01. After controlling for the effects of psychosocial problems and pain, nutrition status remained a significant predictor of distress, explaining 3.8% of the variance in the distress scores of the patients (p < 0.05). Conclusions Malnutrition and symptoms were strongly related to distress in patients with advanced head-and-neck cancer. Our results suggest the need for further research into the complex relationship between nutrition status and distress and into the management of both nutrition and distress in cancer care. PMID:24311956

  18. Interactions of malnutrition and immune impairment, with specific reference to immunity against parasites

    PubMed Central

    HUGHES, S; KELLY, P

    2006-01-01

    KEY POINTS Clinical malnutrition is a heterogenous group of disorders including macronutrient deficiencies leading to body cell mass depletion and micronutrient deficiencies, and these often coexist with infectious and inflammatory processes and environmental problems.There is good evidence that specific micronutrients influence immunity, particularly zinc and vitamin A. Iron may have both beneficial and deleterious effects depending on circumstances.There is surprisingly slender good evidence that immunity to parasites is dependent on macronutrient intake or body composition. PMID:17042929

  19. Effect of Short-Term Supplementation with Ready-to-Use Therapeutic Food or Micronutrients for Children after Illness for Prevention of Malnutrition: A Randomised Controlled Trial in Uganda

    PubMed Central

    van der Kam, Saskia; Roll, Stephanie; Swarthout, Todd; Edyegu-Otelu, Grace; Matsumoto, Akiko; Kasujja, Francis Xavier; Casademont, Cristian; Shanks, Leslie; Salse-Ubach, Nuria

    2016-01-01

    Background Globally, Médecins Sans Frontières (MSF) treats more than 300,000 severely malnourished children annually. Malnutrition is not only caused by lack of food but also by illnesses and by poor infant and child feeding practices. Breaking the vicious cycle of illness and malnutrition by providing ill children with nutritional supplementation is a potentially powerful strategy for preventing malnutrition that has not been adequately investigated. Therefore, MSF investigated whether incidence of malnutrition among ill children <5 y old could be reduced by providing a fortified food product or micronutrients during their 2-wk convalescence period. Two trials, one in Nigeria and one in Uganda, were conducted; here, we report on the trial that took place in Kaabong, a poor agropastoral region of Karamoja, in east Uganda. While the region of Karamoja shows an acute malnutrition rate between 8.4% and 11.5% of which 2% to 3% severe malnutrition, more than half (58%) of the population in the district of Kaabong is considered food insecure. Methods and Findings We investigated the effect of two types of nutritional supplementation on the incidence of malnutrition in ill children presenting at outpatient clinics during March 2011 to April 2012 in Kaabong, Karamoja region, Uganda, a resource-poor region where malnutrition is a chronic problem for its seminomadic population. A three-armed, partially-blinded, randomised controlled trial was conducted in children diagnosed with malaria, diarrhoea, or lower respiratory tract infection. Non-malnourished children aged 6 to 59 mo were randomised to one of three arms: one sachet/d of ready-to-use therapeutic food (RUTF), two sachets/d of micronutrient powder (MNP), or no supplement (control) for 14 d for each illness over 6 mo. The primary outcome was the incidence of first negative nutritional outcome (NNO) during the 6 mo follow-up. NNO was a study-specific measure used to indicate progression to moderate or severe acute

  20. Growth and behavior development in rural infants in relation to malnutrition and environment.

    PubMed

    Upadhyay, S K; Saran, A; Agarwal, D K; Singh, M P; Agarwal, K N

    1992-05-01

    A group of 224 children from a rural cohort of 625 children registered from 1981 to 1983 in 10 villages of KV Block, Varanasi was assessed for morbidity, physical growth, and behavior development (Gesell's developmental schedule). By first birthday children of normal nutrition grade were reduced to one fourth and numbers in Grade II and III malnutrition doubled. This deterioration in nutritional status was probably due to high morbidity, i.e., gastrointestinal, respiratory infections, etc. The skull circumference was 43 cm at the age of one year, being lower by 3 cm than the average size. Children having Grades II and III malnutrition showed poor development in all the areas of behavior, i.e., motor, adaptive, language and personal social. Besides malnutrition, environmental factors like mother's involvement in teaching, encouraging the child, talking to him or being within the visual range; the parental education, their caste and the child's birth order contributed significantly to the development of the child during infancy. PMID:1500108

  1. Malnutrition in Renal Failure: Pleiotropic Diagnostic Approaches, Inefficient Therapy and Bad Prognosis.

    PubMed

    Knap, Bojan; Arnol, Miha; Romozi, Karmen; Marn Pernat, Andreja; Gubenšek, Jakob; Ponikvar, Rafael; Buturović-Ponikvar, Jadranka; Večerić-Haler, Željka

    2016-06-01

    Malnutrition is very common and connected with high morbidity and mortality of patients on chronic hemodialysis. A cross-sectional, longitudinal study was performed in maintenance dialysis patients intending to determine association between modified Subjective Global Assessment (SGA), serum albumin and mortality. Cross-sectional study of phase angle (PhA) values and other indices of bioelectrical impedance body analysis (BIA) were correlated to biochemical data and malnutrition-inflammation score (MIS). In the group of 184 hemodialysis patients, we found 39 malnourished patients. In overall 50 months of observation, 25 out of 39 malnourished patients died. All patients with albumin values less than 30 g/L died. The group with albumin values greater than 30 g/L (N = 26) showed higher survival rate, 12 patients died in the observed period. SGA values higher than 21 and albumin values lower than 30 g/L are useful predictors of death in malnourished dialysis patients. PhA is an independent predictor of malnutrition with promising potential to replace other diagnostic tools. PMID:27312914

  2. Malnutrition Identified by the Nutritional Risk Index and Poor Prognosis in Advanced Epithelial Ovarian Carcinoma.

    PubMed

    Yim, Ga Won; Eoh, Kyung Jin; Kim, Sang Wun; Nam, Eun Ji; Kim, Young Tae

    2016-07-01

    Ovarian cancer is a chronic disease with a risk of malnutrition. Nutritional Risk Index (NRI) has been reported as a simple and accurate tool to assess the nutritional status. We sought to explore the prevalence of malnutrition and its association with survival in ovarian cancer. A retrospective study was conducted in 213 advanced ovarian cancer patients. NRI was calculated before and at the end of treatment using patients' body weight and serum albumin level. Overall survival (OS) and progression-free survival (PFS) were estimated by Kaplan-Meier method, and associations were assessed using a Cox proportional hazards analysis adjusted for known prognostic variables. Moderate to severely malnourished patients had lower 5-yr OS (45.3%) compared to normal to mild group (64.0%), respectively (P = 0.024). Adjusted for covariates, the relative risk of death was 5.8 times higher in moderate/severely malnourished group identified at the last course of chemotherapy (HR = 5.896, 95% CI = 2.723-12.764, P < 0.001). Similarly, this cohort had shorter PFS compared with normal to mild risk group (median 15 vs. 28 months, P = 0.011). Malnutrition is prevalent among ovarian cancer patients and is found to be a significant predictor for mortality. PMID:27044606

  3. Challenges of malnutrition care among HIV-infected children on antiretroviral treatment in Africa.

    PubMed

    Jesson, J; Leroy, V

    2015-05-01

    More than 90% of the estimated 3.2 million children with HIV worldwide, at the end of 2013, were living in sub-Saharan Africa. The management of these children was still difficult in 2014 despite the progress in access to antiretroviral drugs. A great number of HIV-infected children are not diagnosed at 6 weeks and start antiretroviral treatment late, at an advanced stage of HIV disease complicated by other comorbidities such as malnutrition. Malnutrition is a major problem in the sub-Saharan Africa global population; it is an additional burden for HIV-infected children because they do not respond as well as non-infected children to the usual nutritional care. HIV infection and malnutrition interact, creating a vicious circle. It is important to understand the relationship between these 2 conditions and the effect of antiretroviral treatment on this circle to taking them into account for an optimal management of pediatric HIV. An improved monitoring of growth during follow-up and the introduction of a nutritional support among HIV-infected children, especially at antiretroviral treatment initiation, are important factors that could improve response to antiretroviral treatment and optimize the management of pediatric HIV in resource-limited countries. PMID:25861689

  4. Knowledge Discovery in a Community Data Set: Malnutrition among the Elderly

    PubMed Central

    Kim, Hyeyoung; Kim, Sun Kyung

    2014-01-01

    Objectives The purpose of this study was to design a prediction model that explains the characteristics of elderly adults at risk of malnutrition. Methods Data were obtained from a large data set, 2008 Korean Elderly Survey, in which the data of 15,146 subjects were entered. With nutritional status a target variable, the input variables included the demographic and socioeconomic status of participants. The data were analyzed by using the SPSS Clementine 12.0 program's feature selection node to select meaningful variables. Results Among the C5.0, C&R Tree, QUEST, and CHAID models, the highest predictability was reported by C&R Tree with the accuracy rate of 77.1%. The presence of more than two comorbidities, living alone status, having severe difficulty in daily activities, and lower perceived economic status were identified as risk factors of malnutrition in elderly. Conclusions A reliable decision support model was designed to provide accurate information regarding the characteristics of elderly individuals with malnutrition. The findings demonstrated the good feasibility of data mining when used for a large community data set and its value in assisting health professionals and local decision makers to come up with effective strategies for achieving public health goals. PMID:24627816

  5. New concepts on nutritional management of severe malnutrition: the role of protein.

    PubMed

    Scherbaum, V; Fürst, P

    2000-01-01

    Current guidelines for the management of severe malnutrition are mainly based on new concepts regarding the causes of malnutrition and on advances in our knowledge of the physiological roles of micronutrients. In contrast to the early 'protein dogma', there is a growing body of evidence that severely malnourished children are unable to tolerate large amounts of dietary protein during the initial phase of treatment. Similarly, great caution must be exercised to avoid excessive supply of iron and sodium in the diet, while keeping energy intake at maintenance levels during early treatment. Because severely malnourished children require special micronutrients, a mineral-vitamin mix is added to the milk-based formula diets, which are specially designed for the initial treatment and the rehabilitation phase. To further improve nutritional rehabilitation and reduce cases of relapse, 'ready-to-use therapeutic food' and 'ready-to-eat nutritious supplements' with relatively low protein (10% protein calories) and high fat content (54-59% lipidic calories) have been developed. Although current dietary recommendations do not differentiate between oedematous and nonoedematous forms of malnutrition or between adults and children, there are indications that further clarification is still needed for applying dietary measures for specific target groups. PMID:10642081

  6. Child malnutrition and the Millennium Development Goals: much haste but less speed?

    PubMed

    Oruamabo, Raphael S

    2015-02-01

    The Millennium Development Goals (MDGs) provide a framework for measuring the progress of nations. Several of these goals relate to child malnutrition, which remains an important contributor to child morbidity and mortality, accounting for approximately 45% of child deaths globally. A high proportion of undernourished children still live in Africa and parts of Asia, and the uneven rate of reduction in the prevalence of various types of child malnutrition among different income groups worldwide is worrying. Attempts to reduce child malnutrition should therefore begin from the grassroots by improving primary healthcare services in developing countries with particular focus on basic requirements. Adequate nutrition should be provided from birth, through infancy, preschool and early childhood to adolescence. The overall strategy should be one of careful and meticulous planning involving all development sectors with an emphasis on a bottom-up approach within a stable and disciplined polity; the MDGs will be only be useful if they are seen not as narrow objectives with unidirectional interventions but as multifaceted and co-ordinated. The setting of deadlines, whether 2015 or 2035, should not be emphasised so as to avoid hasty decision making. The top priority should be the implementation of the essential social services of basic education, primary healthcare, nutrition, reproductive health care, water and sanitation in partnership with the developed economies. PMID:25613961

  7. Effects of chronic inhalation of volatile solvents, malnutrition and their interaction on seizures induced by pentylenetetrazole in rats.

    PubMed

    Palencia, G; Calvillo, M; Benita, A; Sotelo, J

    1998-10-01

    Chronic inhalation of volatile solvents induce severe brain damage. In humans, intense exposure to volatile solvents for recreational purposes is frequently associated with chronic malnutrition. We studied in rats the effects of chronic inhalation of volatile solvents and malnutrition, alone and combined, on the seizures induced by pentylenetetrazole. Animals were subjected to 14 months of either normal rodent diet or malnutrition induced by a diet based on corn derivatives; some animals were subjected for the last 4 months to daily inhalation of volatile solvents (paint thinner). Afterwards, a trial of pentylenetetrazole-induced seizures was conducted in all animals. When compared with controls, malnutrition, chronic inhalation of volatile solvents and their combination greatly reduced the threshold for both, the forebrain and the brain stem components of seizures. However, an expected lowering of the threshold when malnutrition and solvent inhalation were combined was not observed when compared with each condition alone. It is possible that malnutrition plus solvents exposure induce severe brain damage that interferes with the brain structures involved in the propagation of epileptic seizures. PMID:26735120

  8. Using extended concentration and achievement indices to study socioeconomic inequality in chronic childhood malnutrition: the case of Nigeria

    PubMed Central

    Uthman, Olalekan A

    2009-01-01

    Objectives To assess and quantify the magnitude of inequalities in under-five child malnutrition, particularly those ascribable to socio-economic status Methods Data on 4187 under-five children were derived from the Nigeria 2003 Demographic and Health Survey. Household asset index was used as the main indicator of socio-economic status. Socio-economic inequality in chronic childhood malnutrition was measured using the "extended" illness concentration and achievement indices. Results There are considerable pro-rich inequalities in the distribution of stunting. South-east and south-west regions had low average levels of childhood malnutrition, but the inequalities between the poor and the better-off were very large. By contrast, North-east and North-west had fairly small gaps between the poor and the better-off on childhood malnutrition, but the average values of the childhood malnutrition was extremely high. Conclusion There are significant differences in under-five child malnutrition that favour the better-off of society as a whole and all geopolitical regions. Like other studies have reported, reliance on global averages alone can be misleading. Thus there is a need for evaluating policies not only in terms of improvements in averages, but also improvements in distribution. PMID:19500356

  9. Acute liver injury with severe coagulopathy in marasmus caused by a somatic delusional disorder.

    PubMed

    Stein, Lance L; Jesudian, Arun B

    2011-01-01

    Marasmus is a severe form of protein-calorie malnutrition characterized by the depletion of fat stores, muscle wasting, and the lack of edema. In developed countries, marasmus is often the result of anorexia nervosa. Abnormal transaminases with liver synthetic dysfunction have rarely been reported with anorexia nervosa. To our knowledge, we report the first detailed case of acute liver injury with severe coagulopathy (INR > 1.5) in a patient with marasmus due to self-induced calorie restriction caused by a somatic delusional disorder. This case highlights the severity of liver injury that may occur with significant weight loss from self-induced calorie restriction and the rapid normalization of this injury with treatment. It is important for clinicians to be aware of patterns of acute liver injury in patients with severe protein-calorie malnutrition, regardless of the underlying cause. PMID:25954537

  10. The global problems of child malnutrition and mortality in different world regions.

    PubMed

    El-Ghannam, Ashraf Ragab

    2003-01-01

    The study of child mortality occupies a special place in the field of demographic research, since it represents the negative component of population growth. Also, the world food problem has become a familiar topic since the end of the World War II. The idea that population growth will sometime in the future outrun food supplies and universal starvation occurs. This study deals with what happened in global and regional variations regarding the child malnutrition and mortality rates. The main objective of the study is to explain and to explore the effect of the social, demographic, economic and health factors on child malnutrition and mortality rates among different regions in the globe. The study includes ten regions of the whole world compared to other studies that covered only one or two regions. Data were collected from various sources. The sample involved 191 countries. These countries divided by regions of world as following. East Southern Africa, West Africa, East Asia and Pacific, South Asia, Eastern Europe and Central Asia, Europe, Middle East, North Africa, North America, and South America. The results of descriptive analysis show that the highest mean rate of child malnutrition was found in South Asia region (57 children per 100), while the smallest mean rate was found in Europe region (just 1 child per 100). In West Africa region, the average of child mortality rate per 1000, 172 children, was the highest among all regions in the world, while in Europe was found to be 14 children per 1000. The results of correlation coefficients reveal that there were positive associations between illiteracy rate, unemployment, poverty, fertility rate, family size, food consumption, maternal mortality rate, population per physician, and child malnutrition and mortality in the whole world regions. Some regions have strong significant associations, such as Sub-Saharan Africa, Asia, and Americas, and other were non-significant association, such as Europe, Middle East, and

  11. Acute nephritic syndrome

    MedlinePlus

    Glomerulonephritis - acute; Acute glomerulonephritis; Nephritis syndrome - acute ... Acute nephritic syndrome is often caused by an immune response triggered by an infection or other disease. Common causes ...

  12. Disease-Homologous Mutation in the Cation Diffusion Facilitator Protein MamM Causes Single-Domain Structural Loss and Signifies Its Importance

    PubMed Central

    Barber-Zucker, Shiran; Uebe, René; Davidov, Geula; Navon, Yotam; Sherf, Dror; Chill, Jordan H.; Kass, Itamar; Bitton, Ronit; Schüler, Dirk; Zarivach, Raz

    2016-01-01

    Cation diffusion facilitators (CDF) are highly conserved, metal ion efflux transporters that maintain divalent transition metal cation homeostasis. Most CDF proteins contain two domains, the cation transporting transmembrane domain and the regulatory cytoplasmic C-terminal domain (CTD). MamM is a magnetosome-associated CDF protein essential for the biomineralization of magnetic iron-oxide particles in magnetotactic bacteria. To investigate the structure-function relationship of CDF cytoplasmic domains, we characterized a MamM M250P mutation that is synonymous with the disease-related mutation L349P of the human CDF protein ZnT-10. Our results show that the M250P exchange in MamM causes severe structural changes in its CTD resulting in abnormal reduced function. Our in vivo, in vitro and in silico studies indicate that the CTD fold is critical for CDF proteins’ proper function and support the previously suggested role of the CDF cytoplasmic domain as a CDF regulatory element. Based on our results, we also suggest a mechanism for the effects of the ZnT-10 L349P mutation in human. PMID:27550551

  13. Disease-Homologous Mutation in the Cation Diffusion Facilitator Protein MamM Causes Single-Domain Structural Loss and Signifies Its Importance.

    PubMed

    Barber-Zucker, Shiran; Uebe, René; Davidov, Geula; Navon, Yotam; Sherf, Dror; Chill, Jordan H; Kass, Itamar; Bitton, Ronit; Schüler, Dirk; Zarivach, Raz

    2016-01-01

    Cation diffusion facilitators (CDF) are highly conserved, metal ion efflux transporters that maintain divalent transition metal cation homeostasis. Most CDF proteins contain two domains, the cation transporting transmembrane domain and the regulatory cytoplasmic C-terminal domain (CTD). MamM is a magnetosome-associated CDF protein essential for the biomineralization of magnetic iron-oxide particles in magnetotactic bacteria. To investigate the structure-function relationship of CDF cytoplasmic domains, we characterized a MamM M250P mutation that is synonymous with the disease-related mutation L349P of the human CDF protein ZnT-10. Our results show that the M250P exchange in MamM causes severe structural changes in its CTD resulting in abnormal reduced function. Our in vivo, in vitro and in silico studies indicate that the CTD fold is critical for CDF proteins' proper function and support the previously suggested role of the CDF cytoplasmic domain as a CDF regulatory element. Based on our results, we also suggest a mechanism for the effects of the ZnT-10 L349P mutation in human. PMID:27550551

  14. Using the BacMam Baculovirus System to Study Expression and Function of Recombinant Efflux Drug Transporters in Polarized Epithelial Cell Monolayers

    PubMed Central

    Fung, King Leung; Kapoor, Khyati; Pixley, Jessica N.; Talbert, Darrell J.; Kwit, Alexandra D.T.; Ambudkar, Suresh V.

    2016-01-01

    The ATP-binding cassette (ABC) transporter superfamily includes several membrane-bound proteins that are critical to drug pharmacokinetics and disposition. Pharmacologic evaluation of these proteins in vitro remains a challenge. In this study, human ABC transporters were expressed in polarized epithelial cell monolayers transduced using the BacMam baculovirus gene transfer system. The purpose of the study was to evaluate the efficacy of BacMam baculovirus to transduce cells grown in monolayers. In a porcine kidney cell line, LLC-PK1 cells, baculoviral transduction is successful only via the apical side of a polarized monolayer. We observed that recombinant ABC transporters were expressed on the cell surface with post-translational modification. Furthermore, sodium butyrate played a critical role in recombinant protein expression, and preincubation in the presence of tunicamycin or thapsigargin enhanced protein expression. Cells overexpressing human P-glycoprotein (P-gp) showed vectorial basolateral-to-apical transport of [3H]-paclitaxel, which could be reversed by the inhibitor tariquidar. Similarly, coexpression of human P-gp and ABCG2 in LLC-PK1 cells resulted in higher transport of mitoxantrone, which is a substrate for both transporters, than in either P-gp– or ABCG2-expressing cells alone. Taken together, our results indicate that a high level of expression of efflux transporters in a polarized cell monolayer is technically feasible with the BacMam baculovirus system PMID:26622052

  15. Prevalence, profile and predictors of malnutrition in children with congenital heart defects: a case–control observational study

    PubMed Central

    Okoromah, Christy A N; Ekure, Ekanem N; Lesi, Foluso E A; Okunowo, Wahab O; Tijani, Bolande O; Okeiyi, Jonathan C

    2011-01-01

    Objective To investigate the prevalence, profile and predictors of severe malnutrition in children with congenital heart defects (CHDs). Design Case–control, observational study. Setting Tertiary teaching hospital in Lagos, Nigeria (March 2006 to March 2008). Participants Children aged 3–192 months with uncorrected symptomatic CHD and healthy controls, frequency matched for age and sex. Main outcome measures Prevalence of malnutrition based on WHO/National Center for Health Statistics/Centers for Disease Control and Prevention z score ≤−2; weight for age, weight for height/length and height for age; proportions of underweight, wasting and stunting in cases and controls, and in acyanotic and cyanotic CHD; and predictors of malnutrition using multivariate logistic analysis. Results 90.4% of cases and 21.1% of controls had malnutrition (p=0.0001), and 61.2% and 2.6%, respectively, had severe malnutrition (p=0.0001). Wasting, stunting and underweight were identified in 41.1%, 28.8% and 20.5%, and 2.6%, 3.9% and 14.5% of cases and controls, respectively. Wasting was significantly higher (58.3%) in acyanotic CHD (p=0.0001), and stunting (68.0%) in cyanotic CHD (p=0.0001). Age at weaning was significantly lower in cases than controls (3.24±0.88 and 7.04±3.04 months, respectively; p=0.0001) and in acyanotic than cyanotic CHD (2.14±0.33 and 5.33±1.22 months, respectively; p=0.004). Predictors of malnutrition in CHD were anaemia, moderate to severe congestive heart failure (CHF), poor dietary intake of fat and prolonged unoperated disease. Conclusion Severe malnutrition in association with anaemia and moderate to severe CHF is highly prevalent in CHD preoperatively in these children. Early weaning may be a marker of feeding difficulties in heart failure. PMID:21266339

  16. Malnutrition among children under the age of five in the Democratic Republic of Congo (DRC): does geographic location matter?

    PubMed Central

    2011-01-01

    Background Although there are inequalities in child health and survival in the Democratic Republic of Congo (DRC), the influence of distal determinants such as geographic location on children's nutritional status is still unclear. We investigate the impact of geographic location on child nutritional status by mapping the residual net effect of malnutrition while accounting for important risk factors. Methods We examine spatial variation in under-five malnutrition with flexible geo-additive semi-parametric mixed model while simultaneously controlling for spatial dependence and possibly nonlinear effects of covariates within a simultaneous, coherent regression framework based on Markov Chain Monte Carlo techniques. Individual data records were constructed for children. Each record represents a child and consists of nutritional status information and a list of covariates. For the 8,992 children born within the last five years before the survey, 3,663 children have information on anthropometric measures. Our novel empirical approach is able to flexibly determine to what extent the substantial spatial pattern of malnutrition is driven by detectable factors such as socioeconomic factors and can be attributable to unmeasured factors such as conflicts, political, environmental and cultural factors. Results Although childhood malnutrition was more pronounced in all provinces of the DRC, after accounting for the location's effects, geographic differences were significant: malnutrition was significantly higher in rural areas compared to urban centres and this difference persisted after multiple adjustments. The findings suggest that models of nutritional intervention must be carefully specified with regard to residential location. Conclusion Childhood malnutrition is spatially structured and rates remain very high in the provinces that rely on the mining industry and comparable to the level seen in Eastern provinces under conflicts. Even in provinces such as Bas-Congo that

  17. Clinical impact of malnutrition on complication rate and length of stay in elective ENT patients: a prospective cohort study.

    PubMed

    Kisser, U; Kufeldt, J; Adderson-Kisser, C; Becker, S; Baumeister, P; Reiter, M; Harréus, U; Thomas, M N; Rittler, P

    2016-08-01

    Malnutrition is considered as an independent risk factor for morbidity, mortality and a prolonged hospital stay for in-hospital patients. While most available data on the impact of malnutrition on health-related and financial implications refer to gastroenterologic or abdominal surgery patients, little is known about the impact of malnutrition on Ear Nose Throat (ENT)/head and neck surgery patients. The objective of this study was to investigate the impact of malnutrition on morbidity and length of hospital stay in an elective ENT/head and neck surgery patient cohort. The study was performed as a single-center, prospective cohort study at a tertiary referral centre. Nutritional risk at admission was assessed using the NRS-2002 screening tool. Multivariate regression models were used to determine independent risk factors for complications and a prolonged hospitalization. Three hundred fifty one participants were included in the study. A malignant disease was found in 62 participants (17.7 %). 62 patients (17.7 %) were at a moderate to severe risk of malnutrition. A bad general health condition and complications during hospital stay could be identified as independent risk factors for a prolonged hospitalization. Patients with a malignant tumor showed a more than fourfold higher risk of developing at least one complication. Malnutrition, however, was not statistically associated with a higher complication rate or a prolonged hospital stay. Our data suggests that malnutrition does not seem to play such an important role as a risk factor for complications and a prolonged hospital stay in ENT patients as it does in other disciplines like abdominal surgery or gastroenterology. PMID:26993656

  18. Acute sacroiliitis.

    PubMed

    Slobodin, Gleb; Rimar, Doron; Boulman, Nina; Kaly, Lisa; Rozenbaum, Michael; Rosner, Itzhak; Odeh, Majed

    2016-04-01

    The purpose of this study was to review the data on the etiology, risk factors, clinical presentations, and diagnosis of acute sacroiliitis. A Pubmed search utilizing the indexing term "acute sacroiliitis" was conducted and the data pertinent to the aim of the review was extracted and organized in accordance with the preplanned structure of the manuscript. The diagnosis of acute sacroiliitis is often challenging because of both the relative rarity of this presentation and diverse character of acute sacroiliac pain, frequently mimicking other, more prevalent disorders. Technetium bone scintigraphy can localize the disease process to the sacroiliac joint, while computed tomography or magnetic resonance imaging can be used for the detailed characterization and the extent of the disease as well as the diagnosis of complications. Pyogenic sacroiliitis is by far the most common cause of acute sacroiliitis. Brucellosis, acute sacroiliitis in the course of reactive arthritis, and crystalline-induced sacroiliitis frequently imitate pyogenic sacroiliitis. Acute sacroiliitis can rarely be also related to hematological malignancies or treatment with isotretinoin. Awareness to the possibility of acute sacroiliitis and a thorough physical examination are the necessary prerequisites to its timely diagnosis, while the appropriate laboratory and imaging studies should confirm the precise diagnosis and direct the appropriate treatment strategy. PMID:26847855

  19. Feeding Patterns and Predictors of Malnutrition in Infants from Poor Socioeconomic Areas in Pakistan: A Cross-sectional Survey

    PubMed Central

    Anwar ul Haq, Malik Muhammad; Tariq, Saad; Anwar, Madiha; Khawar, Anam; Waqas, Ahmed; Nisar, Anam

    2016-01-01

    Introduction: Malnutrition, a state of under or over nutrition caused by improper food intake, causes significant morbidity and mortality in developing countries. It leads to a number of diseases which can be further divided into those caused by protein-caloric malnutrition and those caused by vitamin deficiencies, micronutrient, and mineral deficiencies. The purpose of this study was to identify the factors which contribute to malnutrition and to assess the dietary pattern in the pediatric population from birth up to five months belonging to poor socioeconomic areas. The children in this sample presented to a tertiary care hospital in the district of Sargodha, Pakistan. The findings in this cohort will support the development of an effective plan to tackle these issues. Methods: This cross-sectional study was undertaken between June 2014 and December 2014 at the inpatient pediatric department of District Headquarter Hospital Sargodha. Data were collected and recorded on a predesigned form which consisted of four sections to record 1) demographics: parents' level of education, monthly income, number of dependent household members, and birth interval; 2) anthropometric and personal history, birth history, and degree of malnutrition; 3) any secondary causes of malnutrition; and 4) feeding history. The data were analyzed in SPSS v. 20. Chi-squared, phi statistics, and logistic regression analysis were run to analyze the data. Results: A total of 294 participants were included in the study. Logistic regression analysis showed that the degree of malnutrition was associated negatively with increasing age and positively with family size. A majority of children (144, 49%) were being breastfed for less than 5 minutes followed by 38 (13%) > 5 minutes to 15 minutes, and 2 (0.7%) > 15 minutes while 110 (37 %) infants were not breastfed. Children who were breastfed were less likely to have severe malnutrition than those who were given formula, fresh cow's or goat's milk

  20. Home based therapy for severe malnutrition with ready-to-use food

    PubMed Central

    Manary, M; Ndkeha, M; Ashorn, P; Maleta, K; Briend, A

    2004-01-01

    Background: The standard treatment of severe malnutrition in Malawi often utilises prolonged inpatient care, and after discharge results in high rates of relapse. Aims: To test the hypothesis that the recovery rate, defined as catch-up growth such that weight-for-height z score >0 (WHZ, based on initial height) for ready-to-use food (RTUF) is greater than two other home based dietary regimens in the treatment of malnutrition. Methods: HIV negative children >1 year old discharged from the nutrition unit in Blantyre, Malawi were systematically allocated to one of three dietary regimens: RTUF, RTUF supplement, or blended maize/soy flour. RTUF and maize/soy flour provided 730 kJ/kg/day, while the RTUF supplement provided a fixed amount of energy, 2100 kJ/day. Children were followed fortnightly. Children completed the study when they reached WHZ >0, relapsed, or died. Outcomes were compared using a time-event model. Results: A total of 282 children were enrolled. Children receiving RTUF were more likely to reach WHZ >0 than those receiving RTUF supplement or maize/soy flour (95% v 78%, RR 1.2, 95% CI 1.1 to 1.3). The average weight gain was 5.2 g/kg/day in the RTUF group compared to 3.1 g/kg/day for the maize/soy and RTUF supplement groups. Six months later, 96% of all children that reached WHZ >0 were not wasted. Conclusions: Home based therapy of malnutrition with RTUF was successful; further operational work is needed to implement this promising therapy. PMID:15155403

  1. Relationship between child feeding practices and malnutrition in 7 remote and poor counties, P R China.

    PubMed

    Zhou, Hong; Wang, Xiao-Li; Ye, Fang; Zeng, Xiaopei Lily; Wang, Yan

    2012-01-01

    The World Health Organization reported that inappropriate feeding in children is responsible for one-third of the cases of malnutrition. This cross-sectional study aimed to determine the prevalence of malnutrition and identify the relationship between feeding practices and malnutrition in children below 5 years, in 7 remote and poor counties of China. A sample of 2201 children and 1978 caregivers were obtained with multistage cluster random sampling. A survey about feeding practices among the caregivers was implemented using a structured questionnaire, and the health status of children was evaluated using anthropometric measurements. We found 5 problems: first, high prevalence of stunting, underweight and wasting in children below 5 years old (19.3%, 13.1% and 5.5%); second, short duration of breastfeeding for children below 36 months; third, low prevalence of exclusive breastfeeding among children below 6 months of age and continued breastfeeding to 1 year (17.5% and 32.2%). Fourth, although most of the infants (81.1%) between 6 and 8 months of age were given complementary foods, some of the 6- to 8-month-old infants did not receive any complementary foods. Last, a higher prevalence of stunting among Chinese children who had never been breastfed, who had been breastfed for less than 1 year, or had been fed with semi-solid foods of poor quality. Therefore, we suggest that more programs to increase caregivers' feeding knowledge and practices be conducted, to improve the health of children in remote and poor areas in China. PMID:22507610

  2. Regional inequalities in child malnutrition in Egypt, Jordan, and Yemen: a Blinder-Oaxaca decomposition analysis.

    PubMed

    Sharaf, Mesbah Fathy; Rashad, Ahmed Shoukry

    2016-12-01

    There is substantial evidence that on average, urban children have better health outcomes than rural children. This paper investigates the underlying factors that account for the regional disparities in child malnutrition in three Arab countries, namely; Egypt, Jordan, and Yemen. We use data on a nationally representative sample from the most recent rounds of the Demographic and Health Survey. A Blinder-Oaxaca decomposition analysis is conducted to decompose the rural-urban differences in child nutrition outcomes into two components; one that is explained by regional differences in the level of the determinants (covariate effects), and another component that is explained by differences in the effect of the determinants on the child nutritional status (coefficient effects). Results show that the under-five stunting rates are 20 % in Egypt, 46.5 % in Yemen, and 7.7 % in Jordan. The rural- urban gap in child malnutrition was minor in the case of Egypt (2.3 %) and Jordan (1.5 %), while the regional gap was significant in the case of Yemen (17.7 %). Results of the Blinder-Oaxaca decomposition show that the covariate effect is dominant in the case of Yemen while the coefficients effect dominates in the case of Jordan. Income inequality between urban and rural households explains most of the malnutrition gap. Results were robust to the different decomposition weighting schemes. By identifying the underlying factors behind the rural- urban health disparities, the findings of this paper help in designing effective intervention measures aimed at reducing regional inequalities and improving population health outcomes. PMID:27271178

  3. Malnutrition in the First Year of Life and Personality at Age 40

    PubMed Central

    Galler, Janina R.; Bryce, Cyralene P.; Zichlin, Miriam L.; Waber, Deborah P.; Exner, Natalie; Fitzmaurice, Garrett M.; Costa, Paul T.

    2013-01-01

    Background Early childhood malnutrition is associated with cognitive and behavioral impairment during childhood and adolescence, but studies in adulthood are limited. Methods Using the NEO-PI-R personality inventory, we compared personality profiles at 37–43 years of age (mean 40.3 years, SD 1.9) of Barbadian adults who had experienced moderate to severe protein-energy malnutrition (PEM) in the first year of life (n=77) with healthy controls, who were former classmates of the index cases and were matched for age, sex and handedness in childhood (n=57). The previously malnourished participants had been rehabilitated, with good health and nutrition documented to 12 years of age, and study participants were followed longitudinally from childhood to 40 y. Group comparisons were adjusted for childhood and adolescent standard of living, with and without correcting for IQ. Results At the broad domain or factor level, previously malnourished participants had higher scores on Neuroticism and lower scores on Extraversion, Openness, Agreeableness and Conscientiousness than did the healthy controls At the sub-domain or facet level, previously malnourished participants reported more anxiety, vulnerability, shyness and lowered sociability, less intellectual curiosity, greater suspiciousness of others, a more egocentric than altruistic orientation, and a lowered sense of efficacy or competence. Conclusions Malnutrition limited to the first year of life with good health and nutrition documented to 12 years of age, is associated with a significant overrepresentation of adult personality trait scores outside of the average range. This outcome has important implications for a variety of important life and mental health outcomes. PMID:23488644

  4. Climate change and human health: Spatial modeling of water availability, malnutrition, and livelihoods in Mali, Africa

    USGS Publications Warehouse

    Jankowska, M.M.; Lopez-Carr, D.; Funk, C.; Husak, G.J.; Chafe, Z.A.

    2012-01-01

    This study develops a novel approach for projecting climate trends in the Sahel in relation to shifting livelihood zones and health outcomes. Focusing on Mali, we explore baseline relationships between temperature, precipitation, livelihood, and malnutrition in 407 Demographic and Health Survey (DHS) clusters with a total of 14,238 children, resulting in a thorough spatial analysis of coupled climate-health dynamics. Results suggest links between livelihoods and each measure of malnutrition, as well as a link between climate and stunting. A 'front-line' of vulnerability, related to the transition between agricultural and pastoral livelihoods, is identified as an area where mitigation efforts might be usefully targeted. Additionally, climate is projected to 2025 for the Sahel, and demographic trends are introduced to explore how the intersection of climate and demographics may shift the vulnerability 'front-line', potentially exposing an additional 6 million people in Mali, up to a million of them children, to heightened risk of malnutrition from climate and livelihood changes. Results indicate that, holding constant morbidity levels, approximately one quarter of a million children will suffer stunting, nearly two hundred thousand will be malnourished, and over one hundred thousand will become anemic in this expanding arid zone by 2025. Climate and health research conducted at finer spatial scales and within shorter projected time lines can identify vulnerability hot spots that are of the highest priority for adaptation interventions; such an analysis can also identify areas with similar characteristics that may be at heightened risk. Such meso-scale coupled human-environment research may facilitate appropriate policy interventions strategically located beyond today's vulnerability front-line. ?? 2011 Elsevier Ltd.

  5. [The fight against malnutrition in older adults: new aproaches in dentistry].

    PubMed

    Prêcheur, Isabelle; Chevalier, Marlène

    2015-03-01

    A minimal oral treatment aiming a clean and comfortable mouth could be very helpful in malnutrition control of dependent elderly persons. In such a case, it is necessary and generally it is enough to perform dental scaling and/or extractions with anxiolytic premedication (oral or rectal diazepam). Most of times, such minimal dental care can be performed at bedside, avoiding patient's stress and displacement to a dental surgery. The nursing staff can reassure the residents and their families on the absence of dentures, because saliva would be even more important than teeth. Actually, there is a tight relation between oral health, saliva, drugs, food texture and nutritional state of person. The notion of saliva includes two important criteria: 1) saliva-bacteria in the saliva, 2) fluid saliva-oral biofilm covering mucous membranes. All factors which change saliva secretion or inhibit oral bacteria community may lead to malnutrition. Several studies performed in hospital geriatric wards and in retirement homes allowed us to identify the following iatrogenic causes for malnutrition: 1) inappropriate preservation of teeth or dentures which may lead to oral reservoir (Candida albicans yeast-hyphal transition, antibiotic resistance genes transfer); 2) excessive uses of antiseptic mouthwashes for oral hygiene (leading to oral biofilm inhibition which is a cause of xerostomia); 3) drugs crushed in food (alteration of food taste and alteration of the oral biofilm); 4) exclusive recourse to a soft or mixed texture of food (alternative solutions exist, such as texture-adapted protein rich cookies). All these iatrogenic practices raise the possibility of formation of thick microbial communities in the mouth. This would explain why, despite attentive oral care, most of nurses and nurse's aides feel that in retirement homes the oral hygiene of the many residents is insufficient. PMID:25786420

  6. Risk Factors Associated with Malnutrition in One-Year-Old Children Living in the Peruvian Amazon

    PubMed Central

    Joseph, Serene A.; Casapía, Martín; Blouin, Brittany; Maheu-Giroux, Mathieu; Rahme, Elham; Gyorkos, Theresa W.

    2014-01-01

    Background Children under two years of age are in the most critical window for growth and development. As mobility increases, this time period also coincides with first exposure to soil-transmitted helminth (STH) infections in tropical and sub-tropical environments. The association between malnutrition and STH infection, however, has been understudied in this vulnerable age group. Methodology/Principal Findings A nested cross-sectional survey was conducted in 12 and 13-month old children participating in a deworming trial in Iquitos, an STH-endemic area of the Peruvian Amazon. An extensive socio-demo-epi questionnaire was administered to the child's parent. Length and weight were measured, and the Bayley Scales of Infant and Toddler Development were administered to measure cognition, language, and fine motor development. Stool specimens were collected to determine the presence of STH. The association between malnutrition (i.e. stunting and underweight) and STH infection, and other child, maternal, and household characteristics, was analyzed using multivariable Poisson regression. A total of 1760 children were recruited between September 2011 and June 2012. Baseline data showed a prevalence of stunting and underweight of 24.2% and 8.6%, respectively. In a subgroup of 880 randomly-allocated children whose specimens were analyzed by the Kato-Katz method, the prevalence of any STH infection was 14.5%. Risk factors for stunting in these 880 children included infection with at least one STH species (aRR = 1.37; 95% CI 1.01, 1.86) and a lower development score (aRR = 0.97; 95% CI: 0.95, 0.99). A lower development score was also a significant risk factor for underweight (aRR = 0.92; 95% CI: 0.89, 0.95). Conclusions The high prevalence of malnutrition, particularly stunting, and its association with STH infection and lower developmental attainment in early preschool-age children is of concern. Emphasis should be placed on determining the most cost

  7. Acute malocclusion.

    PubMed

    Dupont, John S

    2006-01-01

    Acute malocclusion can result from disturbances in the maxillary/mandibular tooth relationship. These alterations in the occlusal position can result from high fillings, sinus problems, abscesses, periodontal disease, and moving or erupting teeth. Conditions seen less frequently include acute malocclusions secondary to an event (such as trauma) that make a stable dental relationship an unstable one. Patients can demonstrate any of a number of clinical conditions that interfere with their comfort and ability to function. This article provides information on some of the less familiar causes of acute malocclusion. PMID:16689064

  8. Anaerococcus rubiinfantis sp. nov., isolated from the gut microbiota of a Senegalese infant with severe acute malnutrition.

    PubMed

    Tidjani Alou, Maryam; Khelaifia, Saber; Michelle, Caroline; Andrieu, Claudia; Armstrong, Nicholas; Bittar, Fadi; Sokhna, Cheikh; Diallo, Aldiouma; Fournier, Pierre-Edouard; Raoult, Didier; Million, Matthieu

    2016-08-01

    Anaerococcus rubiinfantis sp. nov. strain mt16(T) is a new species within the genus Anaerococcus, which was isolated by the culturomics approach from the gut microbiota of an infant suffering from kwashiorkor. A phenotypic, biochemical and proteomic description of this strain is hereby presented alongside a complete annotation of its genome. This strictly anaerobic species forms Gram-positive non-sporeforming cocci. The major fatty acid was hexadecanoic acid. The phylogenetic analysis of strain mt16(T) showed a 97.9% similarity level with Anaerococcus vaginalis, the closest validly published species. Its genome is 1,929,161 bp long with 29.5% G + C content and contains 1808 protein-coding genes and 56 RNA genes, among which are six rRNA genes. Genomic analysis identified 41/1864 coding genes as ORFans (2.2%) and at least 620/1808 (34.9%) orthologous proteins which are not shared with the closest phylogenetic species. We believe that the extension of the human anaerobic gut compendium by culturomics is one of the first steps that will improve the understanding of the links between the microbiome and health or disease. PMID:27328611

  9. INCIDENCE OF, AND RISK FACTORS FOR, MALNUTRITION AMONG CHILDREN AGED 5-7 YEARS IN SOUTH INDIA.

    PubMed

    Jeyaseelan, Visalakshi; Jeyaseelan, Lakshmanan; Yadav, Bijesh

    2016-05-01

    Protein-energy malnutrition is a major health problem contributing to the burden of disease in developing countries. The aim of this study was to assess the incidence of, and risk factors for, malnutrition among school-going children in south India. A total of 2496 children aged 5-7 years from rural and urban areas of south India were recruited in 1982 and followed up for malnutrition over a period of 9 years. Their body heights and weights were measured every six months and socio-demographic factors such as mother's education and father's education and relevant household characteristics and hygiene practices collected. Body mass index and height-for-age z-scores were used to determine children's levels of underweight and stunting, respectively, classified as normal, mild/moderate or severe. Risk factor analysis was done for pre-pubertal ages only using Generalized Estimating Equations with cumulative odds assumption. There was a significant difference between male and female children in the incidence of severe underweight and stunting (6.4% and 4.2% respectively). Children in households with no separate kitchen had 1.3 (1.0-1.6) times higher odds of being severely underweight (p=0.044) compared with those with a kitchen. Children without a toilet facility had significantly higher odds of severe underweight compared with those who did. Children with illiterate parents had higher odds of severe stunting than those with literate parents. In conclusion, the prevalence of malnutrition among these south Indian children has not changed over the years, and the incidence of severe malnutrition was highest in children when they were at pubertal age. The risk factors for stunting were mostly poverty-related, and those for underweight were mostly hygiene-related. Adolescent children in south India should be screened periodically at school for malnutrition and provided with nutritional intervention if necessary. PMID:26440753

  10. The Effect of Gender and Social Capital on the Dual Burden of Malnutrition: A Multilevel Study in Indonesia

    PubMed Central

    Vaezghasemi, Masoud; Öhman, Ann; Eriksson, Malin; Hakimi, Mohammad; Weinehall, Lars; Kusnanto, Hari; Ng, Nawi

    2014-01-01

    Introduction The paradoxical phenomenon of the coexistence of overweight and underweight individuals in the same household, referred to as the “dual burden of malnutrition”, is a growing nutrition dilemma in low- and middle-income countries (LMICs). Aims The objectives of this study were (i) to examine the extent of the dual burden of malnutrition across different provinces in Indonesia and (ii) to determine how gender, community social capital, place of residency and other socio-economic factors affect the prevalence of the dual burden of malnutrition. Methods The current study utilized data from the fourth wave of the Indonesian Family Life Survey (IFLS) conducted between November 2007 and April 2008. The dataset contains information from 12,048 households and 45,306 individuals of all ages. This study focused on households with individuals over two years old. To account for the multilevel nature of the data, a multilevel multiple logistic regression was conducted. Results Approximately one-fifth of all households in Indonesia exhibited the dual burden of malnutrition, which was more prevalent among male-headed households, households with a high Socio-economic status (SES), and households in urban areas. Minimal variation in the dual burden of malnutrition was explained by the community level differences (<4%). Living in households with a higher SES resulted in higher odds of the dual burden of malnutrition but not among female-headed households and communities with the highest social capital. Conclusion To improve household health and reduce the inequality across different SES groups, this study emphasizes the inclusion of women's empowerment and community social capital into intervention programs addressing the dual burden of malnutrition. PMID:25153321

  11. Malnutrition as a cause of mental retardation: A population-based study from Sub-Himalayan India

    PubMed Central

    Raina, Sunil Kumar; Sharma, Shailja; Bhardwaj, Ashok; Singh, Mitasha; Chaudhary, Sanjeev; Kashyap, Vipasha

    2016-01-01

    Background: Mental retardation is one of the most common disabilities of childhood. The research on childhood malnutrition and its relationship with cognitive functioning suggests that malnutrition alone does not cause mental retardation. Objective: To identify the relation between malnutrition and cognition among children from a Sub-Himalayan state in North India. Materials and Methods: A two-phase cross-sectional study was conducted in the rural, urban, and slum area of district Kangra. A 30-cluster sampling technique was used to screen a population of children 1–10 years of age from five randomly selected panchayats (village government units) of district Kangra. The screening was based on a modified version of the ten questions screen, adapted to the local population. In the first phase, a door-to-door survey was done to identify suspects of mental retardation. In the second phase, the children found positive in the first phase were called for clinical examination to confirm mental retardation. Anthropometric assessment of all study children was done by measuring weight and height. The nutritional assessment was done by categorizing them according to Waterlow classification for malnutrition. Results: Out of the total 5300 children, 1.7% were diagnosed as mentally retarded. No positive association was reported with different types of malnutrition and mental retardation. A weakly positive association existed between nutritional status and mental retardation (correlation coefficient-0.04). Children who were both wasted and stunted had the highest risk (odds ratio, 95% confidence interval – 5.57, 2.29–10.36) of mental retardation as compared to normal. Conclusion: Malnutrition may be one of the causes but certainly not the only cause of mental retardation. Other causes may be contributing more significantly toward it. PMID:27365949

  12. Tackling malnutrition: a systematic review of 15-year research evidence from INDEPTH health and demographic surveillance systems

    PubMed Central

    Arthur, Samuelina S.; Nyide, Bongiwe; Soura, Abdramane Bassiahi; Kahn, Kathleen; Weston, Mark; Sankoh, Osman

    2015-01-01

    Background Nutrition is the intake of food in relation to the body's dietary needs. Malnutrition results from the intake of inadequate or excess food. This can lead to reduced immunity, increased susceptibility to disease, impaired physical and mental development, and reduced productivity. Objective To perform a systematic review to assess research conducted by the International Network for the Demographic Evaluation of Populations and their Health (INDEPTH) of health and demographic surveillance systems (HDSSs) over a 15-year period on malnutrition, its determinants, the effects of under and over nutrition, and intervention research on malnutrition in low- and middle-income countries (LMICs). Methods Relevant publication titles were uploaded onto the Zotero research tool from different databases (60% from PubMed). Using the keywords ‘nutrition’, ‘malnutrition’, ‘over and under nutrition’, we selected publications that were based only on data generated through the longitudinal HDSS platform. All titles and abstracts were screened to determine inclusion eligibility and full articles were independently assessed according to inclusion/exclusion criteria. For inclusion in this study, papers had to cover research on at least one of the following topics: the problem of malnutrition, its determinants, its effects, and intervention research on malnutrition. One hundred and forty eight papers were identified and reviewed, and 67 were selected for this study. Results The INDEPTH research identified rising levels of overweight and obesity, sometimes in the same settings as under-nutrition. Urbanisation appears to be protective against under-nutrition, but it heightens the risk of obesity. Appropriately timed breastfeeding interventions were protective against malnutrition. Conclusions Although INDEPTH has expanded the global knowledge base on nutrition, many questions remain unresolved. There is a need for more investment in nutrition research in LMICs in order to

  13. Malnutrition among 3 to 5 years old children in Baghdad city, Iraq: a cross-sectional study.

    PubMed

    Ghazi, Hasanain Faisal; Mustafa, Jamsiah; Aljunid, Syed; Isa, Zaleha; Abdalqader, Mohammed A

    2013-09-01

    The unstable geopolitical situation in Iraq since 2003 still affects the health of people, especially children. Several factors may indirectly affect a child's nutritional status. The main aim of this study was to identify factors contributing to malnutrition among 3 to 5 years old children in Baghdad city, Iraq. Two hundred twenty children aged 3 to 5 years were chosen randomly from four kindergartens in Baghdad city according to the cross-sectional design. The nutritional status of the children was assessed using a weight-for-age z-score based on the World Health Organization 2007 cutoff points, in which any child with a z-score of <-2 is considered to be malnourished. The overall prevalence rate of underweight children was 18.2%. There was no significant difference in the prevalence rate between males and females (p=0.797). However, the percentage of underweight children was slightly higher among females (18.9%) compared to males (17.6%). There was no association between parents' educational level or employment status and childhood malnutrition. There was no association between a family's movement from their house and childhood malnutrition (p=0.322). Living in an unsafe neighbourhood and having a family member killed during the past five years were significantly associated with childhood malnutrition (p=0.016 and 0.018 respectively). Childhood malnutrition is still a public-health concern in Baghdad city, especially after the war of 2003. Malnutrition is significantly associated with living in unsafe neighbourhoods and at least one family member having been killed during the past five years. PMID:24288949

  14. Malnutrition among 3 to 5 Years Old Children in Baghdad City, Iraq: A Cross-sectional Study

    PubMed Central

    Mustafa, Jamsiah; Aljunid, Syed; Isa, Zaleha Md.; Abdalqader, Mohammed A.

    2013-01-01

    The unstable geopolitical situation in Iraq since 2003 still affects the health of people, especially children. Several factors may indirectly affect a child's nutritional status. The main aim of this study was to identify factors contributing to malnutrition among 3 to 5 years old children in Baghdad city, Iraq. Two hundred twenty children aged 3 to 5 years were chosen randomly from four kindergartens in Baghdad city according to the cross-sectional design. The nutritional status of the children was assessed using a weight-for-age z-score based on the World Health Organization 2007 cutoff points, in which any child with a z-score of <-2 is considered to be malnourished. The overall prevalence rate of underweight children was 18.2%. There was no significant difference in the prevalence rate between males and females (p=0.797). However, the percentage of underweight children was slightly higher among females (18.9%) compared to males (17.6%). There was no association between parents’ educational level or employment status and childhood malnutrition. There was no association between a family's movement from their house and childhood malnutrition (p=0.322). Living in an unsafe neighbourhood and having a family member killed during the past five years were significantly associated with childhood malnutrition (p=0.016 and 0.018 respectively). Childhood malnutrition is still a public-health concern in Baghdad city, especially after the war of 2003. Malnutrition is significantly associated with living in unsafe neighbourhoods and at least one family member having been killed during the past five years. PMID:24288949

  15. Crystallization scale purification of α7 nicotinic acetylcholine receptor from mammalian cells using a BacMam expression system

    PubMed Central

    Cheng, Hao; Fan, Chen; Zhang, Si-wei; Wu, Zhong-shan; Cui, Zhi-cheng; Melcher, Karsten; Zhang, Cheng-hai; Jiang, Yi; Cong, Yao; Xu, H Eric

    2015-01-01

    Aim: To report our methods for expression and purification of α7 nicotinic acetylcholine receptor (α7-nAChR), a ligand-gated pentameric ion channel and an important drug target. Methods: α7-nAChRs of 10 different species were cloned into an inducible BacMam vector with an N-terminal tag of a tandem maltose-binding protein (MBP) and a TEV cleavage site. This α7-nAChR fusion receptor was expressed in mammalian HEK293F cells and detected by Western blot. The expression was scaled up to liters. The receptor was purified using amylose resin and size-exclusion chromatography. The quality of the purified receptor was assessed using SDS-PAGE gels, thermal stability analysis, and negative stain electron microscopy (EM). The expression construct was optimized through terminal truncations and site-directed mutagenesis. Results: Expression screening revealed that α7-nAChR from Taeniopygia guttata had the highest expression levels. The fusion receptor was expressed mostly on the cell surface, and it could be efficiently purified using one-step amylose affinity chromatography. One to two milligrams of the optimized α7-nAChR expression construct were purified from one liter of cell culture. The purified α7-nAChR samples displayed high thermal stability with a Tm of 60 °C, which was further enhanced by antagonist binding but decreased in the presence of agonist. EM analysis revealed ring-like structures with a central hydrophilic hole, which was consistent with the pentameric assembly of the α7-nAChR channel. Conclusion: We have established methods for crystallization scale expression and purification of α7-nAChR, which lays a foundation for high-resolution structural studies using X-ray crystallography or single particle cryo-EM analysis. PMID:26073323

  16. Lentil and Kale: Complementary Nutrient-Rich Whole Food Sources to Combat Micronutrient and Calorie Malnutrition.

    PubMed

    Migliozzi, Megan; Thavarajah, Dil; Thavarajah, Pushparajah; Smith, Powell

    2015-11-01

    Lentil (Lens culinaris Medik.) is a nutritious food and a staple for millions of people. Not only are lentils a good source of energy, they also contain a range of micronutrients and prebiotic carbohydrates. Kale (Brassica oleracea v. acephala) has been considered as a health food, but its full range of benefits and composition has not been extensively studied. Recent studies suggest that foods are enrich in prebiotic carbohydrates and dietary fiber that can potentially reduce risks of non-communicable diseases, including obesity, cancer, heart disease, and diabetes. Lentil and kale added to a cereal-based diet would enhance intakes of essential minerals and vitamins to combat micronutrient malnutrition. This review provides an overview of lentil and kale as a complementary nutrient-rich whole food source to combat global malnutrition and calorie issues. In addition, prebiotic carbohydrate profiles and the genetic potential of these crops for further micronutrient enrichment are briefly discussed with respect to developing sustainable and nutritious food systems. PMID:26569296

  17. Microbial perturbations and modulation in conditions associated with malnutrition and malabsorption.

    PubMed

    Jonkers, Daisy M A E

    2016-04-01

    The intestinal microbiota is a complex ecosystem, which can be considered an accessory organ. It involves complex microbe-microbe and host-microbe interactions with indispensable functions for the human host with regard to the intestinal epithelium and barrier function, the innate and adaptive immune system, and its large metabolic capacity. Saccharolytic fermentation results in the production of short chain fatty acids, which exert an array of beneficial effects, while proteolytic fermentation leads to an increase in potentially harmful metabolites. In addition, numerous other microbial metabolites are being produced with various intestinal as well as extra-intestinal effects. Their generation depends on the composition of the microbiota as well as the availability of substrates, which both vary along the GI tract. Diet impacts the intestinal microbiota composition and activity in early infancy as well as in adults. Microbial perturbations have been demonstrated in subjects with under-nutrition and/or malabsorption. The bidirectional interactions between the microbiome, nutrient availability and GI function, can contribute to a vicious circle, further impairing health outcome in conditions associated with malnutrition and/or malabsorption. Integrated multivariate approaches are needed to further unravel the complex interaction between microbiome, diet and host factors, as well as possible modulation thereof by prebiotics or probiotics. The present overview will briefly outline the composition and function of the intestinal microbiota, its association with nutrient intake and availability, and will address the role of the intestinal microbiota in malnutrition and malabsorption. PMID:27086883

  18. Epidemiological evaluation regarding the role of cystic fibrosis as a risk factor for child malnutrition.

    PubMed

    Florescu, Laura; Paduraru, Dana Teodora Anton; Mîndru, Dana Elena; Temneanu, Oana Raluea; Petrariu, F D; Matei, Mioara Calipsoana

    2014-01-01

    Cystic fibrosis (CF) is the most common monogenic autosomal recessive disorder with progressive chronic evolution which is potentially lethal. Poor growth is a characteristic of children suffering from cystic fibrosis. A poor nutritional status is an independent risk factor for inadequate survival in cystic fibrosis and is associated with disease complications. The appropriate nutritional management is an important part of the treatment so that the patient with cystic fibrosis can achieve normal growth and development and maintain the best possible health status. A balanced diet supplemented with snacks high in fat and calories is necessary to increase the caloric intake in children with cystic fibrosis. Children with cystic fibrosis have higher caloric needs than healthy children of the same age and sex. Malnutrition in CF is multifactorial. Cystic fibrosis is a complex multisystem disorder affecting mainly the gastrointestinal tract and respiratory system. In the past, malnutrition was an inevitable consequence of disease progression, leading to poor growth, impaired respiratory muscle function, decreased exercise tolerance and immunological impairment. A positive association between body weight and height and survival has been widely reported. The energy requirements of patients with CF vary widely and generally increase with age and disease severity. Cystic fibrosis remains a paediatric disorder which is often underdiagnosed but which, if therapeutically managed properly (by means of drug therapy as well as by appropriate physiotherapy techniques), can lead to improved quality of life and, thus, to a bigger life expectancy. PMID:25076714

  19. Effect of Malnutrition and Morbid Obesity on Complication Rates Following Primary Total Joint Arthroplasty.

    PubMed

    Courtney, P Maxwell; Rozell, Joshua C; Melnic, Christopher M; Sheth, Neil P; Nelson, Charles L

    2016-01-01

    The purpose of this study is to identify any association between malnutrition and morbid obesity and determine if either independently increases complications following primary total joint arthroplasty (TJA). The study retrospectively reviewed a series of 670 patients who underwent primary TJA at a single institution. Patients were categorized as malnourished if their preoperative serum albumin was <3.5 mg/dL and morbidly obese if their body mass index was >40 kg/m(2). Of the 670 patients in the study, 83 patients were malnourished (12.4%), while 125 patients (18.7%) were morbidly obese. Morbidly obese patients were more likely to be malnourished than nonmorbidly obese patients (19% vs. 11%, p = .010). Malnutrition is an independent risk factor for complications [adjusted odds ratio (OR) 3.00, 95% confidence interval (CI) 1.56-5.75]. Morbid obesity was not independently associated with a significant increase (adjusted OR 1.82, 95% CI 0.70-4.71). Preoperative screening with serum albumin, particularly in morbidly obese patients, can identify at-risk patients for complications. PMID:27518294

  20. Effect of Malnutrition on the Expression of Cytokines Involved in Th1 Cell Differentiation

    PubMed Central

    González-Torres, Cristina; González-Martínez, Haydeé; Miliar, Angel; Nájera, Oralia; Graniel, Jaime; Firo, Verónica; Alvarez, Catalina; Bonilla, Edmundo; Rodríguez, Leonor

    2013-01-01

    Malnutrition is a common cause of secondary immune deficiency and has been linked to an increased susceptibility to infection in humans. Malnutrition specifically affects T-cell-mediated immune responses. The aim of this study was to assess in lymphocytes from malnourished children the expression levels of IL-12, IL-18 and IL-21, molecules that induce the differentiation of T cells related to the immunological cellular response (Th1 response) and the production of cytokines related to the immunological cellular response (Th1 cytokines). We found that the expression levels of IL-12, IL-18 and IL-21 were significantly diminished in malnourished children compared to well-nourished children and were coincident with lower plasmatic levels of IL-2 and IFN-γ (Th1 cytokines). In this study, we show for the first time that the gene expression and intracellular production of cytokines responsible for Th1 cell differentiation (IL-12, IL-18 and IL-21) are diminished in malnourished children. As expected, this finding was related to lower plasmatic levels of IL-2 and IFN-γ. The decreased expression of Th1 cytokines observed in this study may contribute to the deterioration of the immunological Type 1 (cellular) response. We hypothesize that the decreased production of IL-12, IL-18 and IL-21 in malnourished children contributes to their inability to eradicate infections. PMID:23429441

  1. Transgenic foods as a tool for malnutrition elimination and their impact on agricultural systems.

    PubMed

    Monastra, Giovanni; Rossi, Laura

    2003-01-01

    GMO crops were introduced for commercial production in 1996. Since then, their use has increased rapidly. GMOs have primarily benefited large farms and multinational companies in Industrialised Countries and now is more and more debating their utilisation in Developing World. The objective of the present review is an analysis of this subject from a comprehensive point of view; in addition to that, the changes related to the nutritional content of transgenic foods will be treated. Despite the progress that has been made, the world food situation is still marked by mass hunger and chronic malnutrition. In particular micronutrient malnutrition, that means vitamin and mineral deficiencies, represents an important public health problem in several areas of the world. The "golden rice" bioengineered to contain beta-carotene, as a source of vitamin A is the most famous example of GM food used for reduction (or even to solve) of a public health problem. The expected results of this approach have presently not been achieved. Further studies are necessary to increase the general knowledge about GMOs and their long-term effects on human health. Collaborative attitude of different research sectors (private and public) and involvement of different sectors of society will be an added value for comprehension of the real impact of the application of modern biotechnology to food and agriculture systems. PMID:15055878

  2. Lentil and Kale: Complementary Nutrient-Rich Whole Food Sources to Combat Micronutrient and Calorie Malnutrition

    PubMed Central

    Migliozzi, Megan; Thavarajah, Dil; Thavarajah, Pushparajah; Smith, Powell

    2015-01-01

    Lentil (Lens culinaris Medik.) is a nutritious food and a staple for millions of people. Not only are lentils a good source of energy, they also contain a range of micronutrients and prebiotic carbohydrates. Kale (Brassica oleracea v. acephala) has been considered as a health food, but its full range of benefits and composition has not been extensively studied. Recent studies suggest that foods are enrich in prebiotic carbohydrates and dietary fiber that can potentially reduce risks of non-communicable diseases, including obesity, cancer, heart disease, and diabetes. Lentil and kale added to a cereal-based diet would enhance intakes of essential minerals and vitamins to combat micronutrient malnutrition. This review provides an overview of lentil and kale as a complementary nutrient-rich whole food source to combat global malnutrition and calorie issues. In addition, prebiotic carbohydrate profiles and the genetic potential of these crops for further micronutrient enrichment are briefly discussed with respect to developing sustainable and nutritious food systems. PMID:26569296

  3. Malnutrition in Dialysis Patients--The Need for Intervention Despite Uncertain Benefits.

    PubMed

    Kovesdy, Csaba P

    2016-01-01

    We are in the midst of an epidemic of overnutrition which has resulted in a widespread increase in obesity rates in modern societies. Yet for patients suffering from serious chronic illnesses such as end stage renal disease (ESRD), malnutrition (encompassing both inadequate quantity and quality of nutrient intake) represents a far more significant danger. Protein-energy wasting has been identified as one of the strongest risk factor for adverse outcomes in ESRD patients, and modeling studies have suggested that improving nutrition could result in substantial lowering of mortality rates and other benefits. To date there is ample evidence that various interventions can have a positive impact on the nutritional status of ESRD patients, yet we still lack randomized controlled clinical trials showing that the same interventions could indeed lead to better survival or other clinical benefits. This knowledge gap, which is all too common for clinical problems encountered in nephrology, should not act as a deterrent, but it should rather incentivize us to continue exploring novel interventions aimed at improving malnutrition in ESRD. PMID:26190025

  4. [Breastfeeding, complimentary feeding practices and childhood malnutrition in the Bolivian Andes].

    PubMed

    Cruz Agudo, Yesmina; Jones, Andrew D; Berti, Peter R; Larrea Macías, Sergio

    2010-03-01

    Northern Potosi is one of the poorest parts of Bolivia with the highest indicators of rural poverty, malnutrition and food insecurity in the Bolivian Andes. The objective of this research was to characterize the levels of malnutrition and describe infant feeding practices in Potosi, Bolivia and use this information to develop an effective, gender sensitive and culturally relevant intervention encouraging good infant feeding practices. Standard methods were used to collect anthropometric data. Weight and height data were collected for 400 children under five years of age from 30 communities. In six of these communities, interviews and focus group discussions were conducted with 33 mothers and other families in addition to household observational data that were collected to describe infant feeding practices. Nearly 20% of children were underweight; stunting was widespread as well. 38% of mothers initiated breastfeeding 12 hours or more after birth. 39% of mothers initiated complementary feeding in the first three months following birth. The type of complementary food given to children was usually inadequate. With this research we could see that nutritional deficiencies often begin when the mother starts breastfeeding and when first introduced complementary feeding. Interventions aimed at improving maternal and child nutrition will require changes in parents' behavior, greater recognition and community support of the importance of child feeding, and the inclusion of strategies to reach young people, involve men, and make high quality nutrition promotion more widely available in the communities. PMID:21090271

  5. Seroprevalence rate of Poliovirus antibodies among the Healthy and Protein Energy Malnutrition children

    PubMed Central

    Yousuf, Aliya; Syed Shah, Skindar Ali; Syed Jaffery, Imtiaz Ahmed; Ahmed, Syed Azher; Khan, M.A Basit; Aslam, Mohammad

    2015-01-01

    Objective: To study the association between Protein energy malnutrition and polio-specific immunoglobulin G antibodies production among children in Gadap Town Karachi, Pakistan. Methods: Comparative cross sectional survey conducted at fixed EPI center and Pediatric OPD of a tertiary care hospital Karachi. Children were selected by convenient sampling method during the period from 17 March to 17 May 2013. It was ensured that they must have received more than seven oral polio vaccine doses as eligibility criteria for the study. A total of 170 blood samples were collected and tested for the presence of polio-specific IgG antibodies using Poliomyelitis IgG ELISA Test Kit produced. Results: Statistically significant relation was found between PEM and IgG antibodies production OR (P = 0.000). Overall Seroprevalence rate among the study population was 98.8%, PEM group 97.6% and healthy group 100%. Conclusion: The study demonstrated that there is a need to focus on the protein energy malnutrition among the children as an immunization strategy for the 100% seroprevalence rate in all population against polio in Pakistan. PMID:26101500

  6. Contaminated weaning food: a major risk factor for diarrhoea and associated malnutrition.

    PubMed Central

    Motarjemi, Y.; Käferstein, F.; Moy, G.; Quevedo, F.

    1993-01-01

    Infections and the malnutrition associated with them are responsible for a significant proportion of the 13 million deaths among infants and children under 5 years of age worldwide each year. After respiratory infections, diarrhoeal diseases are the commonest illnesses and have the greatest negative impact upon the growth of infants and young children. The causes of diarrhoeal diseases have traditionally been ascribed to water supply and sanitation. In attempts to prevent such diseases, efforts by governments and nongovernmental organizations have been focused on and sometimes limited to improving water supply and sanitation as well as promoting and protecting breast-feeding. Based on studies reported in the literature, this review article demonstrates that weaning foods prepared under unhygienic conditions are frequently heavily contaminated with pathogens and thus are a major factor in the cause of diarrhoeal diseases and associated malnutrition. In the light of the evidence presented, it appears that current efforts are not sufficient to prevent diarrhoeal diseases: education of mothers in food safety principles, particularly weaning food, must also receive high priority. Educational programmes based on the hazard-analysis-critical-control-point approach, taking into consideration also sociocultural factors, should be integrated into all national infant feeding or food and nutrition programmes. PMID:8440042

  7. Acute Bronchitis

    MedlinePlus

    ... bronchitis? Acute bronchitis is almost always caused by viruses that attack the lining of the bronchial tree ... infection. As your body fights back against these viruses, more swelling occurs and more mucus is produced. ...

  8. Acute Pericarditis

    MedlinePlus

    ... large pericardial effusions). Acute pericarditis usually responds to colchicine or NSAIDs (such as aspirin and ibuprofen ) taken ... reduce pain but relieves it by reducing inflammation. Colchicine also decreases the chance of pericarditis returning later. ...

  9. Severe malnutrition and metabolic complications of HIV-infected children in the antiretroviral era: clinical care and management in resource-limited settings.

    PubMed

    Musoke, Philippa M; Fergusson, Pamela

    2011-12-01

    More than 2 million children globally are living with HIV infection and >90% of these reside in sub-Saharan Africa. Severe acute malnutrition (SAM) remains a major problem for HIV-infected children who live in resource-limited settings (RLS), and SAM is an important risk factor for mortality. SAM in HIV-infected children is associated with complications including electrolyte disorders, micronutrient deficiencies, and severe infections, which contribute to the high mortality. Access to antiretroviral therapy (ART) has significantly improved the survival of HIV-infected children, although the response to ART of children with SAM remains undocumented in the literature. Immune and virologic responses to ART in RLS are similar to those of infected children in resource-rich settings, but delays in initiation of therapy have led to a high early mortality. Antiretroviral drug toxicities have been described in children who receive therapy and may affect their quality of life and long-term survival. Metabolic complications of ART include lipodystrophy, dyslipidemia, lactic acidosis, insulin resistance, and osteopenia. These complications have been well described in adults and children from developed countries, but data from RLS are limited, and these complications may be compounded by SAM. In this article we review the epidemiology, clinical presentation, and complications of SAM in HIV-infected children and the metabolic complications of HIV-infected children in the era of ART, and discuss future research priorities for RLS. PMID:22089437

  10. Nutrition, the Nervous System, and Behavior. Proceedings of the Seminar on Malnutrition in Early Life and Subsequent Mental Development. (Mona, Jamaica, January 10-14, 1972).

    ERIC Educational Resources Information Center

    Pan American Health Organization, Washington, DC.

    Five years have elapsed since the International Conference on Malnutrition, Learning, and Behavior at the Massachusetts Institute of Technology. The present Seminar was held to examine progress since then. The following papers were presented and discussed: "Malnutrition and the Nervous System," Donald B. Cheek, A. B. Holt, and E. D. Mellits;…

  11. Acute myelogenous leukemia (AML) - children

    MedlinePlus

    Acute myelogenous leukemia - children; AML; Acute myeloid leukemia - children; Acute granulocytic leukemia - children; Acute myeloblastic leukemia - children; Acute non-lymphocytic leukemia (ANLL) - children

  12. Case report of 5 siblings: malnutrition? Rickets? DiGeorge syndrome? Developmental delay?

    PubMed Central

    Cundiff, David K; Harris, William

    2006-01-01

    Background Parents of six children are facing a trial on charges of aggravated manslaughter in the care a 5 1/2 month old infant who died suddenly and neglect of their four older children for causing them to be malnourished by feeding them all an exclusively raw foods vegan diet. Both parents declined plea bargains and plan to defend themselves in court. Case presentation The fifth child born to a married couple was breast-fed until 2 1/2 months. Subsequently, the parents fed the baby an exclusively raw foods diet prepared in a blender at home. The four older children, ages 18 months – 6 1/2 years also ate an exclusively raw foods vegan diet. None of the four older children had significant previous injuries or serious illnesses. At autopsy, the infant weighed 3180 mg (6.99 pounds) and appeared emaciated. The thymus gland was absent and parathyroid glands were not located. The lungs were "congested." DiGeorge anomaly cannot be ruled out from these findings. Although, the coroner ruled that "malnutrition" was the sole cause of death, malnutrition, according to the World Health Organization definition, cannot be diagnosed in this infant. Compared with standard growth charts, the older children fell 2.1–4.1 standard deviations below the mean for North American children in height and weight. Labs were normal except for a low cholesterol level in all and a low prealbumin in one of three children tested. Therefore, malnutrition cannot be diagnosed in these children. The pediatrician diagnosed rickets in the four-year-old. However, chest x-rays were normal in all and long bone x-rays showed minimal changes in one child – no sign of rickets. The clinical diagnosis of rickets was not confirmed by the Center for Disease Control's criteria. A psychologist diagnosed the 18-month-old as developmentally delayed to the level of a 15-month-old, but this diagnosis is questionable. Conclusion The raw foods vegan diet and possibly inherited small stature from the father's side

  13. Leucine Supplementation Improves Acquired Growth Hormone Resistance in Rats with Protein-Energy Malnutrition

    PubMed Central

    Wang, Xinying; Zhao, Jie; Wan, Xiao; Zhang, Li; Wu, Chao; Li, Ning; Li, Jieshou

    2015-01-01

    Background Protein-energy malnutrition (PEM) can lead to growth hormone (GH) resistance. Leucine supplementation diets have been shown to increase protein synthesis in muscles. Our study aimed at investigating if long-term leucine supplementation could modulate GH-insulin-like growth factor (IGF)-1 system function and mammalian target of rapamycin (mTOR)-related signal transduction in skeletal muscles in a rat model of severe malnutrition. Methodology/Principal Findings Male Sprague-Dawley rats (n = 50; weight, 302 ± 5 g) were divided into 5 treatment groups, including 2 control groups (a normal control group that was fed chow and ad libitum water [CON, n = 10] and a malnourished control group [MC, n = 10] that was fed a 50% chow diet). After undergoing a weight loss stage for 4 weeks, rats received either the chow diet (MC-CON, n = 10), the chow diet supplemented with low-dose leucine (MC-L, n = 10), or the chow diet supplemented with high-dose leucine (MC-H, n = 10) for 2 weeks. The muscle masses of the gastrocnemius, soleus, and extensor digitorum longus were significantly reduced in the MC group. Re-feeding increased muscle mass, especially in the MC-L and MC-H groups. In the MC group, serum IGF-1, IGF-binding protein (IGFBP)-3, and hepatic growth hormone receptor (GHR) levels were significantly decreased and phosphorylation of the downstream anabolic signaling effectors protein kinase B (Akt), mTOR, and ribosomal protein S6 kinase 1 (S6K1) were significantly lower than in other groups. However, serum IGF-1 and IGF binding protein (IGFBP)-3 concentrations and hepatic growth hormone receptor (GHR) levels were significantly higher in the MC-L and MC-H groups than in the MC-CON group, and serum IGFBP-1 levels was significantly reduced in the MC-L and MC-H groups. These changes were consistent with those observed for hepatic mRNA expression levels. Phosphorylation of the downstream anabolic signaling effectors Akt, mTOR, and S6K1 were also significantly higher in

  14. Position of the American Dietetic Association: Addressing world hunger, malnutrition, and food insecurity.

    PubMed

    Struble, Marie Boyle; Aomari, Laurie Lindsay

    2003-08-01

    It is the position of the American Dietetic Association (ADA) that access to adequate amounts of safe, nutritious, and culturally appropriate food at all times is a fundamental human right. Hunger continues to be a worldwide problem of staggering proportions. The Association supports programs and encourages practices that combat hunger and malnutrition, produce food security, promote self-sufficiency, and are environmentally and economically sustainable. The Association is aware that hunger exists in a world of plenty and that poverty, gender inequity, ethnocentrism, racism, and the lack of political will are key constraints to solving the problems of global hunger and malnutrition. Recognizing that simplistic approaches are inadequate, the ADA identifies sustainable development as the long-term strategy to ending world hunger and achieving food security. Sustainable development requires political, economic, and social changes that include empowering the disenfranchised, widening access to assets and other resources, narrowing the gap between rich and poor, and adjusting consumption patterns so as to foster good stewardship of nature. Additionally, because the health status of future generations is related to the well-being of their mothers, achieving food security will also require increased access for women to education, adequate health care and sanitation, and economic opportunities. This position paper reviews the complex issues of global food insecurity and discusses long-term solutions for achieving world food security. Achieving the end of world hunger has been and is now within our grasp. There is sufficient food to feed everyone, and solutions can be realized now that will benefit all of humanity. As noted in the paper, most people who examine the costs of ending versus not ending world hunger are bewildered by the question of why humanity did not solve the problem a long time ago. The Association supports programs and encourages practices that combat

  15. The Economic Burden of Malnutrition in Pregnant Women and Children under 5 Years of Age in Cambodia.

    PubMed

    Moench-Pfanner, Regina; Silo, Sok; Laillou, Arnaud; Wieringa, Frank; Hong, Rathamony; Hong, Rathavuth; Poirot, Etienne; Bagriansky, Jack

    2016-01-01

    Malnutrition is locked in a vicious cycle of increased mortality, poor health, impaired cognitive development, slow physical growth, reduced learning capacity, inferior performance, and ultimately lower adult work performance and productivity. The consensus of global scientific evidence indicates that lowering the rates of malnutrition will be an indispensable component of any successful program to raise the quality of human capital and resources. This study used a "consequence model" to apply the coefficient risk-deficit on economic losses, established in the global scientific literature, to Cambodian health, demographic, and economic data to develop a national estimate of the value of economic losses due to malnutrition. The impact of the indicators of malnutrition analyzed represent a burden to the national economy of Cambodia estimated at 266 million USD annually (1.7% of GDP). Stunting is reducing the Cambodian economic output by more than 120 million USD, and iodine deficiency disorders alone by 57 million USD. This economic burden is too high in view of Cambodia's efforts to drive economic development. The government should rapidly expand a range of low-cost effective nutrition interventions to break the current cycle of increased mortality, poor health and ultimately lower work performance, productivity, and earnings. PMID:27187462

  16. Protein Quality, Growth, and Malnutrition: Advances in Science and the Role of Dairy Ingredients in Food Aid: Introduction.

    PubMed

    Whitsett-Morrow, Dacia; LaGrange, Veronique

    2016-03-01

    This article is the introduction to our formal proceedings of the symposium titled "Protein Quality, Growth and Malnutrition: Latest Scientific Findings and the Role of Dairy in Food Aid," held during the Experimental Biology 2015 annual meeting in Boston, Massachusetts. PMID:26880664

  17. The importance of the coding of hospital malnutrition in the health strategy of the European Union: a Spanish contribution.

    PubMed

    Álvarez, J; León, M; Planas, M; García de Lorenzo, A

    2010-01-01

    Malnutrition related to illness and inadequate nutrition remains a matter of relevant interest in the member countries of the European Union because of its elevated prevalence and high costs. It is estimated to affect 30 million patients and cost 170 billion euros annually. The 2008-2013 strategy "Together for Health" put forward in the European Parliament urges Member States to develop, together with local and regional authorities, initiatives in the field of education of the population, training, investigation and good clinical practices. SENPE (Spanish Society of Parenteral and Enteral Nutrition) collaborates in different areas in the development of this strategy which aim to put malnutrition related to illness in the focus of the health system. One of its contributions has been the preparation of the Document of Consensus on the Coding of Malnutrition SENPE-SEDOM (Spanish Society of Medical Documentation). The agreements adopted have helped normalize the process of coding this pathology with the assignment of specific codes for specifically defined terms. This document has allowed the optimization of information regarding the types and degrees of malnutrition and the procedures employed for its prevention or treatment in the hospital centres of the National Health System. PMID:21519757

  18. Micronutrient Action Plan Instructional Tool (MAPit): A Training Tool to Support Public Health Professionals' Efforts to Eliminate Micronutrient Malnutrition

    ERIC Educational Resources Information Center

    Elbon, Suzanne; Nsubuga, Peter; Knowles, Jacky; Bobrow, Emily; Parvanta, Ibrahim; Timmer, Arnold; van der Haar, Frits

    2006-01-01

    Micronutrient malnutrition (MM) is a global health problem that affects the national socioeconomic stability of an affected country. This article describes a multimedia training tool, the Micronutrient Action Plan instructional tool (MAPit), which has been designed to support public health professionals' efforts to eliminate MM. An overview and…

  19. Hospital malnutrition and inflammatory response in critically ill children and adolescents admitted to a tertiary intensive care unit

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Critical illness has a major impact on the nutritional status of both children and adults. A retrospective study was conducted to evaluate the incidence of hospital malnutrition at a pediatric tertiary intensive care unit (PICU). Serum concentrations of IL-6 in subgroups of well-nourished and malnou...

  20. Research Relating to the Learning of Children Identified as Having Experienced Malnutrition and/or Heavy Metal Poisoning. Final Report.

    ERIC Educational Resources Information Center

    Snowdon, Charles T.

    Described was research on the behavioral and learning effects of lead poisoning or malnutrition in rats. It is explained that approximately 200 rats (either weanling, adult, pregnant, or nursing) were injected with various amounts of lead. It was found that symtomatic levels of lead in weanling or adult rats produced no obvious behavioral or…

  1. 'It was caused by the carelessness of the parents': cultural models of child malnutrition in southern Malawi.

    PubMed

    Flax, Valerie L

    2015-01-01

    Parents' conceptions of child growth, health and malnutrition are culturally bound, making information about local understandings of malnutrition and its causes necessary for designing effective nutrition programmes. This study used ethnographic methods to elucidate cultural models of child care and malnutrition among the Yao of southern Malawi. Data were collected in six rural villages from 28 key informant interviews with village chiefs and traditional healers among others and 18 focus group discussions with parents and grandmothers of young children. For the Yao, lack of parental care is a key cause of poor child health and can lead to thinness (kunyililika) or swelling (kuimbangana). Parents are said to be careless if they are not attentive to the child's needs, are unable to provide adequate quality or quantity of food, or fail to follow sexual abstinence rules. Maintaining abstinence protects the family and failure to do so causes the transfer of 'heat' from a sexually active parent to a 'cold' child and results in child health problems, including signs and symptoms of malnutrition. These findings indicate that the Yao understanding of care is much broader than the concept of care during feeding described in the nutrition literature. In addition, the Yao note the importance of several key feeding practices supported by international agencies and understand the influence of illness on child nutritional status. These congruencies with the public health frame should be used together with information about the cultural context to design more socially and emotionally relevant care and nutrition programmes among the Yao. PMID:23941316

  2. The Economic Burden of Malnutrition in Pregnant Women and Children under 5 Years of Age in Cambodia

    PubMed Central

    Moench-Pfanner, Regina; Silo, Sok; Laillou, Arnaud; Wieringa, Frank; Hong, Rathamony; Hong, Rathavuth; Poirot, Etienne; Bagriansky, Jack

    2016-01-01

    Malnutrition is locked in a vicious cycle of increased mortality, poor health, impaired cognitive development, slow physical growth, reduced learning capacity, inferior performance, and ultimately lower adult work performance and productivity. The consensus of global scientific evidence indicates that lowering the rates of malnutrition will be an indispensable component of any successful program to raise the quality of human capital and resources. This study used a “consequence model” to apply the coefficient risk-deficit on economic losses, established in the global scientific literature, to Cambodian health, demographic, and economic data to develop a national estimate of the value of economic losses due to malnutrition. The impact of the indicators of malnutrition analyzed represent a burden to the national economy of Cambodia estimated at 266 million USD annually (1.7% of GDP). Stunting is reducing the Cambodian economic output by more than 120 million USD, and iodine deficiency disorders alone by 57 million USD. This economic burden is too high in view of Cambodia’s efforts to drive economic development. The government should rapidly expand a range of low-cost effective nutrition interventions to break the current cycle of increased mortality, poor health and ultimately lower work performance, productivity, and earnings. PMID:27187462

  3. Validation of nutritional risk index method against patient-generated subjective global assessment in screening malnutrition in colorectal cancer patients

    PubMed Central

    Faramarzi, Elnaz; Mohammad-Zadeh, Mohammad; Nasirimotlagh, Behnam

    2013-01-01

    Objective To validate malnutrition screening tool of nutrition risk index (NRI) against patient-generated subjective global assessment (PG-SGA) as a gold standard tool in colorectal cancer patients before radiotherapy. Methods Nutritional status of 52 volunteer colorectal cancer patients with a mean age of 54.1±16.8 years who referred to radiotherapy center were assessed by PG-SGA (gold standard method) and NRI. Serum albumin levels of patients were determined by colorimetric method. A contingency table was used to determine the sensitivity, specificity, and predictive value of the NRI in screening patients at risk of malnutrition, in comparison with the PG-SGA in patients before radiotherapy. Results The findings of PG-SGA and NRI showed that 52% and 45% of patients in our study were moderately or severely malnourished respectively. The NRI had a sensitivity of 66% and a specificity of 60% against PG-SGA. The positive predictive value was 64% and the negative predicative value was 62%. The agreement between NRI and PG-SGA was statistically insignificant (kappa =0.267; P>0.05). Conclusions The findings of present study showed that the prevalence of malnutrition was high in patients with colorectal cancer. Moreover, NRI method had low sensitivity and specificity in assessing nutritional status of patients with cancer. It seems that the combination of anthropometric, laboratory parameters and a subjective scoring system may be helpful tools in screening of malnutrition in cancer patients. PMID:24255578

  4. Malnutrition and Mental Development: Implications for the Preschool Child: A Review of the Literature 1966-1970.

    ERIC Educational Resources Information Center

    Keefer, Norman; Keefer, Judith

    This document is the compilation of 50 reviews of selected articles, published between 1966-1970, pertaining to the relationship between malnutrition and potential to learn. The materials represent a relatively complete cross-section of the information available on this subject. There are three recurring themes in the publications reviewed. (1) If…

  5. Acute Pneumonia.

    PubMed

    Arshad, Hammad; Fasanya, Adebayo; Cheema, Tariq; Singh, Anil C

    2016-01-01

    Acute pneumonia is an active infection of the lungs that results when an individual at risk gets exposed to a particular microbiological pathogen. Acute pneumonia is the leading cause of death in the United States that is attributable to an infection. The risk factors, pathogenesis, and microbiological organisms involved differ if the pneumonia develops in the community versus health care-associated environment. The development of concise and comprehensive guidelines has led to an improvement in the management of the problem. However, the emergence of multidrug-resistant organisms and the increase in the percentage of elderly population keep mortality risk very substantial. PMID:26919676

  6. Prenatal Protein Malnutrition Decreases KCNJ3 and 2DG Activity in Rat Prefrontal Cortex

    PubMed Central

    Amaral, A.C.; Jakovcevski, M.; McGaughy, J.A.; Calderwood, S.K.; Mokler, D.J.; Rushmore, R.J.; Galler, J.R.; Akbarian, S.A.; Rosene, D.L.

    2014-01-01

    Prenatal protein malnutrition (PPM) in rats causes enduring changes in brain and behavior including increased cognitive rigidity and decreased inhibitory control. A preliminary gene microarray screen of PPM rat prefrontal cortex (PFC) identified alterations in KCNJ3 (GIRK1/Kir3.1), a gene important for regulating neuronal excitability. Follow-up with polymerase chain reaction and Western blot showed decreased KCNJ3 expression in PFC, but not hippocampus or brainstem. To verify localization of the effect to the PFC, baseline regional brain activity was assessed with 14C-2-deoxyglucose. Results showed decreased activation in PFC but not hippocampus. Together these findings point to the unique vulnerability of the PFC to the nutritional insult during early brain development, with enduring effects in adulthood on KCNJ3 expression and baseline metabolic activity. PMID:25446346

  7. Prenatal protein malnutrition decreases KCNJ3 and 2DG activity in rat prefrontal cortex.

    PubMed

    Amaral, A C; Jakovcevski, M; McGaughy, J A; Calderwood, S K; Mokler, D J; Rushmore, R J; Galler, J R; Akbarian, S A; Rosene, D L

    2015-02-12

    Prenatal protein malnutrition (PPM) in rats causes enduring changes in brain and behavior including increased cognitive rigidity and decreased inhibitory control. A preliminary gene microarray screen of PPM rat prefrontal cortex (PFC) identified alterations in KCNJ3 (GIRK1/Kir3.1), a gene important for regulating neuronal excitability. Follow-up with polymerase chain reaction and Western blot showed decreased KCNJ3 expression in the PFC, but not hippocampus or brainstem. To verify localization of the effect to the PFC, baseline regional brain activity was assessed with (14)C-2-deoxyglucose. Results showed decreased activation in the PFC but not hippocampus. Together these findings point to the unique vulnerability of the PFC to the nutritional insult during early brain development, with enduring effects in adulthood on KCNJ3 expression and baseline metabolic activity. PMID:25446346

  8. Effects of food price shocks on child malnutrition: The Mozambican experience 2008/2009.

    PubMed

    Arndt, Channing; Hussain, M Azhar; Salvucci, Vincenzo; Østerdal, Lars Peter

    2016-09-01

    A propitiously timed household survey carried out in Mozambique over the period 2008/2009 permits us to study the relationship between shifts in food prices and child nutrition status in a low income setting. We focus on weight-for-height and weight-for-age in different survey quarters characterized by very different food price inflation rates. Using propensity score matching techniques, we find that these nutrition measures, which are sensitive in the short run, improve significantly in the fourth quarter of the survey, when the inflation rate for basic food products is low, compared to the first semester or three quarters, when food price inflation was generally high. The prevalence of underweight, in particular, falls by about 40 percent. We conclude that the best available evidence points to food penury, driven by the food and fuel price crisis combined with a short agricultural production year, as substantially increasing malnutrition amongst under-five children in Mozambique. PMID:26991234

  9. [Malnutrition due to an extremely 'healthy' diet; a new eating disorder?].

    PubMed

    Nauta, K; Toxopeus, K; Eekhoff, E M W

    2016-01-01

    A 71-year-old male was admitted to our hospital with heart failure, cachexia and biochemical disturbances due to a diet consisting of exclusively vegetables, oil and water. Our investigations showed that this diet was a consequence of an excessive preoccupation with health. The patient did not meet criteria for an eating disorder or other DSM-IV psychiatric disorder. We conclude that malnutrition due to health fad diets may be an underestimated medical problem. There is no specific psychopathological disorder that covers this behaviour, and there is no knowledge of its epidemiology. Popular literature is paying a great deal attention to orthorexia nervosa, an alleged eating disorder that describes a pathological obsession with healthy food. In medical literature this concept has been largely neglected, although eating disorder specialists frequently observe this behaviour in their practice. More clinical and scientific attention for this phenomenon is necessary to determine its epidemiology, validity and clinical picture. PMID:27299484

  10. The role of sanitation in malnutrition--a science and policy controversy in India.

    PubMed

    Dobe, Madhumita

    2015-02-01

    Over the past decade, India's economic growth has been remarkable - yet almost half of India's children under 5 remain stunted. The National Food Security Bill is the country's response to this critical situation. Studies reveal that Indian children are chronically undernourished, not only because of lack of food but also because of recurring gastrointestinal infections. The stunting problem revolves more around lack of sanitation than food insecurity. Despite acknowledging that malnutrition is 'complex and multidimensional', government action has consisted largely of nutritional interventions and subsidized food. Although improvements in sanitation would be the most effective way to reduce excessively high levels of chronic undernutrition and stunting, a review of policy formulation and implementation reveals deficits and disconnects with available scientific evidence. It is time to change these mistaken assumptions and focus on improving access and use of safe sanitation facilities to achieve India's nutritional goals. PMID:25428191

  11. Malaria, malnutrition and MSF. Médecins Sans Frontières.

    PubMed

    Evans, D W

    This is a personal account of my brief time in Burundi as a volunteer doctor with Médecins Sans Frontières (MSF) at the beginning of 2001. Burundi is a small nation in central Africa (bounded by the Democratic Republic of Congo, Rwanda and Tanzania) which has suffered from problems between the Hutu and Tutsi "ethnic groups", similar to those for which Rwanda is better known. Unlike Rwanda, the war between government troops and rebel forces continues in Burundi. MSF has been in Burundi since 1992, providing basic healthcare, nutrition programs, surgical services and epidemiological intervention. In late 2000, a malaria epidemic began in Burundi's highland regions where transmission is normally low, and thus the population largely not immune. Malnutrition rates also increased and MSF rapidly expanded its usual program in an attempt to control these new health problems. PMID:11837845

  12. Aflatoxin Contamination in Food and Body Fluids in Relation to Malnutrition and Cancer Status in Cameroon

    PubMed Central

    Tchana, Angele N.; Moundipa, Paul F.; Tchouanguep, Félicité M.

    2010-01-01

    Aflatoxins are food contaminants usually associated with hepatitis, immunodepression, impairment of fertility and cancer. The present work was to determine the presence of aflatoxins in eggs, milk, urine, and blood samples that were collected from various sources and periods; and hepatitis B virus antigen in blood samples. Aflatoxin was found in eggs (45.2%), cow raw milk (15.9%), breast milk (4.8%), urine from kwashiorkor and marasmic kwashiorkor children (45.5%), and sera from primary liver cancer patients (63.9%); HbsAg was also detected in 69.4% of the serum samples, but there was no association between both factors. Both AF and hepatitis B virus seem to be risk factors that could increase the incidence and prevalence rates of malnutrition and cancer in Cameroon. PMID:20195440

  13. Protein-energy malnutrition is frequent and precocious in children with cri du chat syndrome.

    PubMed

    Lefranc, Violaine; de Luca, Arnaud; Hankard, Régis

    2016-05-01

    Protein-energy malnutrition (PEM) is poorly reported in cri du chat syndrome (CDCS) (OMIM #123450), a genetic disease that causes developmental delay and global growth retardation. The objective was to determine the nutritional status at different ages in children with CDCS and factors associated with PEM. A questionnaire focused on growth and nutritional care was sent to 190 families. Among 36 analyzable questionnaires, growth and nutritional indices compatible with PEM occurred in 47% of patients: 19% before 6 months of age, 24% between 6-12 months and 34% after 12 months. Eight patients received enteral feeding. Speech therapy for swallowing education was performed more often in malnourished children (63% vs. 22%, P < 0.02). PEM is frequent and occurs early in this disease, requiring closed nutritional monitoring. © 2016 Wiley Periodicals, Inc. PMID:26872355

  14. Developmental contributions to macronutrient selection: a randomized controlled trial in adult survivors of malnutrition

    PubMed Central

    Campbell, Claudia P.; Raubenheimer, David; Badaloo, Asha V.; Gluckman, Peter D.; Martinez, Claudia; Gosby, Alison; Simpson, Stephen J.; Osmond, Clive; Boyne, Michael S.; Forrester, Terrence E.

    2016-01-01

    Background and objectives: Birthweight differences between kwashiorkor and marasmus suggest that intrauterine factors influence the development of these syndromes of malnutrition and may modulate risk of obesity through dietary intake. We tested the hypotheses that the target protein intake in adulthood is associated with birthweight, and that protein leveraging to maintain this target protein intake would influence energy intake (EI) and body weight in adult survivors of malnutrition. Methodology: Sixty-three adult survivors of marasmus and kwashiorkor could freely compose a diet from foods containing 10, 15 and 25 percentage energy from protein (percentage of energy derived from protein (PEP); Phase 1) for 3 days. Participants were then randomized in Phase 2 (5 days) to diets with PEP fixed at 10%, 15% or 25%. Results: Self-selected PEP was similar in both groups. In the groups combined, selected PEP was 14.7, which differed significantly (P < 0.0001) from the null expectation (16.7%) of no selection. Self-selected PEP was inversely related to birthweight, the effect disappearing after adjusting for sex and current body weight. In Phase 2, PEP correlated inversely with EI (P = 0.002) and weight change from Phase 1 to 2 (P = 0.002). Protein intake increased with increasing PEP, but to a lesser extent than energy increased with decreasing PEP. Conclusions and implications: Macronutrient intakes were not independently related to birthweight or diagnosis. In a free-choice situation (Phase 1), subjects selected a dietary PEP significantly lower than random. Lower PEP diets induce increased energy and decreased protein intake, and are associated with weight gain. PMID:26817484

  15. Nutritional education for management of osteodystrophy: Impact on serum phosphorus, quality of life, and malnutrition.

    PubMed

    Karavetian, Mirey; Elzein, Hafez; Rizk, Rana; Jibai, Rime; de Vries, Nanne

    2016-07-01

    Introduction Osteodystrophy management includes dietary phosphorus restriction, which may limit protein intake, exacerbate malnutrition-inflammation syndrome and mortality among hemodialysis patients. Methods A multicenter randomized controlled trial was conducted in Lebanon, to test the hypothesis that intensive nutrition education focused on phosphorus-to-protein balance will improve patient outcomes. Six hemodialysis units were randomly assigned to the trained hospital dietitian (THD) protocol (210 patients). Six others (184 patients) were divided equally according to the patients' dialysis shifts and assigned to Dedicated Dietitian (DD) and Control protocols. Patients in the THD group received nutrition education from hospital dietitians who were trained by the study team on renal dietetics, but had limited time for hemodialysis patients. Patients in the DD group received individualized nutritional education on dietary phosphorus and protein management for 6 months (2-hour/patient/month) from study renal dietitians. Patients in the control group continued receiving routine care from hospital dietitians who had limited time for these patients and were blinded to the study. Serum phosphorus (mmol/L), malnutrition-inflammation score (MIS), health-related quality of life (HRQOL) index and length of hospital stay (LOS) were assessed at T0 (baseline), T1 (postintervention) and T2 (post6 month follow up). Findings Only the DD protocol significantly improved serum phosphorus (T0:1.78 ± 0.5, T1:1.63 ± 0.46, T2:1.69 ± 0.53), 3 domains of the HRQOL and maintained MIS at T1, but this protective effect resolved at T2. The LOS significantly dropped for all groups. Discussion The presence of competent renal dietitians fully dedicated to hemodialysis units was superior over the other protocols in temporarily improving patient outcomes. PMID:26843138

  16. Enrichment of food staples through plant breeding: a new strategy for fighting micronutrient malnutrition.

    PubMed

    Bouis, H

    1995-01-01

    The 4 strategies for reducing micronutrient malnutrition are supplementation, fortification, dietary diversification, and disease reduction. Arguments are adduced for investing in a 5th strategy, plant breeding. This long-term strategy has already been taken by the Consultative Group on International Agricultural Research (CGIAR), a group of 17 agricultural research centers seeking to raise farm productivity in developing countries. A coordinated plan has been developed involving collaborative research on 5 major staple food crops (rice, wheat, maize, beans, and cassava) between 5 core research institutes. The feasibility of a plant breeding strategy hinges on 5 core questions: 1) the scientific feasibility and the time needed to breed staple food varieties whose seeds are micronutrient-dense, 2) the effect of breeding micronutrient-dense seeds on plant yields, 3) whether breeding for micronutrient-dense seeds will change processing or consumer characteristics of staple foods, 4) whether micronutrient bioavailability will be increased to a significant degree in staples, and 5) the existence of other inexpensive, sustainable strategies for reducing micronutrient malnutrition. Zinc-dense wheat varieties, developed at the Waite Agricultural Research Institute of the University of Adelaide, are already being grown in Australia. 10 years may be required before nutritionally-improved varieties could be available for commercial production by farmers in developing countries. Such small amounts will not alter the appearance, taste, texture, or cooking quality of foods. If the presently low iron content of food staples could be increased by a factor of 3.5 this would double bioavailable iron. This strategy does hold promise for significantly reducing recurrent expenditures required for these higher-cost, short-run programs by significantly reducing the numbers of people requiring treatment. It would seem prudent to invest now in a plant breeding strategy to maintain momentum

  17. Severe malnutrition in children: high case-fatality rates can be reduced.

    PubMed

    Schofield, C; Ashworth, A

    1997-09-01

    This article offers a protocol for reducing high case fatality rates from malnutrition. Most child deaths from malnutrition occur in the first few days of treatment. Treatment should involve stabilization followed by rehabilitation. The article describes the treatment procedures for hypoglycemia, hypothermia, dehydration, and missed infections and discusses feeding during the stabilization and rehabilitation phases of treatment. All severely malnourished children have excess body sodium but high intracellular and low plasma levels. Malnourished children have deficiencies of potassium and magnesium that may take 2 weeks to correct. Edema is partly due to deficiencies in potassium and magnesium. A high sodium intake can be corrected by rehydrating with a modified oral rehydration solution and the special starter formula. Family food should be prepared without salt. Magnesium and potassium should be added directly to foods. All severely malnourished children have vitamin and mineral deficiencies. Deficiencies may include vitamin A, zinc, copper, selenium, and folic acid. Multivitamin supplements can correct for micronutrient deficiencies. It is advised that zinc should not be ignored, since it is responsible for repair of intestinal mucosa, halting diarrhea, healing of ulcerated skin lesions, restoration of appetite, improved immune function, and lean tissue synthesis. Iron should not be given until growth starts, infections are controlled, and antioxidant status is improved (usually 1 week after admission). Early introduction of iron poses a risk of enhancing pathogen increases and stimulating production of toxic free radicals. Relapses can be reduced by training parents how to feed their child frequently with energy and nutrient dense foods. The regimen was tested in a South African project and found to reduce mortality from 30% to 20%. After greater hospital attention to treatment of sepsis and hypoglycemia, case fatality declined to 6%. PMID:12321237

  18. How to Achieve Transparency in Public-Private Partnerships Engaged in Hunger and Malnutrition Reduction.

    PubMed

    Eggersdorfer, Manfred; Bird, Julia K

    2016-01-01

    Multi-stakeholder partnerships are important facilitators of improving nutrition in developing countries to achieve the United Nations' Sustainable Development Goals. Often, the role of industry is challenged and questions are raised as to the ethics of involving for-profit companies in humanitarian projects. The Second International Conference on Nutrition placed great emphasis on the role of the private sector, including industry, in multi-stakeholder partnerships to reduce hunger and malnutrition. Governments have to establish regulatory frameworks and institutions to guarantee fair competition and invest in infrastructure that makes investments for private companies attractive, eventually leading to economic growth. Civil society organizations can contribute by delivering nutrition interventions and behavioral change-related communication to consumers, providing capacity, and holding governments and private sector organizations accountable. Industry provides technical support, innovation, and access to markets and the supply chain. The greatest progress and impact can be achieved if all stakeholders cooperate in multi-stakeholder partnerships aimed at improving nutrition, thereby strengthening local economies and reducing poverty and inequality. Successful examples of public-private partnerships exist, as well as examples in which these partnerships did not achieve mutually agreed objectives. The key requirements for productive alliances between industry and civil society organizations are the establishment of rules of engagement, transparency and mutual accountability. The Global Social Observatory performed a consultation on conflicts of interest related to the Scaling Up Nutrition movement and provided recommendations to prevent, identify, manage and monitor potential conflicts of interest. Multi-stakeholder partnerships can be successful models in improving nutrition if they meet societal demand with transparent decision-making and execution. Solutions to

  19. An Epidemiological Study of Malnutrition Among Under Five Children of Rural and Urban Haryana

    PubMed Central

    Yadav, Shweta Tomar; Mishra, Prabhaker; Mittal, Anshu; Kumar, Randhir; Singh, Jagjeet

    2016-01-01

    Introduction A child is future of nation. Malnutrition is a big public health problem in India as it can be attributed for more than half (54 percent) of all under five mortality in India. Aim To assess prevalence of malnutrition among urban and rural population of Haryana using newly developed WHO growth standards. Settings and Design A community based cross-sectional survey was conducted in children of 3-60 months age living in the urban and rural field practice areas of Department of Community Medicine MMIMSR, Mullana, Ambala during January 2012 to December 2012. Materials and Methods Seven hundred and fifty children, aged 3-60 months, were studied for nutritional status, socio-demographic measures were obtained from structured questionnaire and followed by anthropometric assessment using standards methods. Z score for Anthropometric data was calculated by WHO Anthro 2010 software (beta version). Statistical Analysis Descriptive statistics as well as simple proportion were calculated with SPSS 20. Results We found that 41.3% children were underweight and 14% were severe underweight. Female children were more nutritionally deprived than males. Among sociodemographic factors maternal educational and working status as well as SES class and rural background of family had greater impact on nutritional status of child. Conclusion We found that almost half of our under five children are underweight, girl child being affected more. For attainment of best possible nutrition and growth in children, targeted short-term strategies addressing underlying risk factors and more long-term poverty alleviation strategies may be needed. PMID:27042487

  20. Burden of childhood diseases and malnutrition in a semi-urban slum in southern India

    PubMed Central

    2013-01-01

    Background India has seen rapid unorganized urbanization in the past few decades. However, the burden of childhood diseases and malnutrition in such populations is difficult to quantify. The morbidity experience of children living in semi-urban slums of a southern Indian city is described. Methods A total of 176 children were recruited pre-weaning from four geographically adjacent, semi-urban slums located in the western outskirts of Vellore, Tamil Nadu for a study on water safety and enteric infections and received either bottled or municipal drinking water based on their area of residence. Children were visited weekly at home and had anthropometry measured monthly until their second birthday. Results A total of 3932 episodes of illness were recorded during the follow-up period, resulting in an incidence of 12.5 illnesses/child-year, with more illness during infancy than in the second year of life. Respiratory, mostly upper respiratory infections, and gastrointestinal illnesses were most common. Approximately one-third of children were stunted at two years of age, and two-thirds had at least one episode of growth failure during the two years of follow up. No differences in morbidity were seen between children who received bottled and municipal water. Conclusions Our study found a high burden of childhood diseases and malnutrition among urban slum dwellers in southern India. Frequent illnesses may adversely impact children’s health and development, besides placing an additional burden on families who need to seek healthcare and find resources to manage illness. PMID:23360429

  1. Serum carnitine as an independent biomarker of malnutrition in patients with impaired oral intake

    PubMed Central

    Iwamoto, Junichi; Honda, Akira; Miyamoto, Yasunori; Miyazaki, Teruo; Murakami, Masashi; Saito, Yoshifumi; Ikegami, Tadashi; Miyamoto, Jiro; Matsuzaki, Yasushi

    2014-01-01

    Carnitine is a vitamin-like compound that plays important roles in fatty acid β-oxidation and the control of the mitochondrial coenzyme A/acetyl-CoA ratio. However, carnitine is not added to ordinary enteral nutrition or total parenteral nutrition. In this study, we determined the serum carnitine concentrations in subjects receiving ordinary enteral nutrition (EN) or total parenteral nutrition (TPN) and in patients with inflammatory bowel diseases to compare its levels with those of other nutritional markers. Serum samples obtained from 11 EN and 11 TPN patients and 82 healthy controls were examined. In addition, 10 Crohn’s disease and 10 ulcerative colitis patients with malnutrition who were barely able to ingest an ordinary diet were also evaluated. Carnitine and its derivatives were quantified using liquid chromatography-tandem mass spectrometry (LC-MS/MS). The carnitine concentrations in EN and TPN subjects were significantly lower compared with those of the control subjects. Neither the serum albumin nor the total cholesterol level was correlated with the carnitine concentration, although a significant positive correlation was found between the serum albumin and total cholesterol levels. Indeed, patients with CD and UC showed significantly reduced serum albumin and/or total cholesterol levels, but their carnitine concentrations remained normal. In conclusion, only a complete blockade of an ordinary diet, such as EN or TPN, caused a reduction in the serum carnitine concentration. Serum carnitine may be an independent biomarker of malnutrition, and its supplementation is needed in EN and TPN subjects even if their serum albumin and total cholesterol levels are normal. PMID:25411530

  2. Effect of nutrition survey 'cleaning criteria' on estimates of malnutrition prevalence and disease burden: secondary data analysis.

    PubMed

    Crowe, Sonya; Seal, Andrew; Grijalva-Eternod, Carlos; Kerac, Marko

    2014-01-01

    Tackling childhood malnutrition is a global health priority. A key indicator is the estimated prevalence of malnutrition, measured by nutrition surveys. Most aspects of survey design are standardised, but data 'cleaning criteria' are not. These aim to exclude extreme values which may represent measurement or data-entry errors. The effect of different cleaning criteria on malnutrition prevalence estimates was unknown. We applied five commonly used data cleaning criteria (WHO 2006; EPI-Info; WHO 1995 fixed; WHO 1995 flexible; SMART) to 21 national Demographic and Health Survey datasets. These included a total of 163,228 children, aged 6-59 months. We focused on wasting (low weight-for-height), a key indicator for treatment programmes. Choice of cleaning criteria had a marked effect: SMART were least inclusive, resulting in the lowest reported malnutrition prevalence, while WHO 2006 were most inclusive, resulting in the highest. Across the 21 countries, the proportion of records excluded was 3 to 5 times greater when using SMART compared to WHO 2006 criteria, resulting in differences in the estimated prevalence of total wasting of between 0.5 and 3.8%, and differences in severe wasting of 0.4-3.9%. The magnitude of difference was associated with the standard deviation of the survey sample, a statistic that can reflect both population heterogeneity and data quality. Using these results to estimate case-loads for treatment programmes resulted in large differences for all countries. Wasting prevalence and caseload estimations are strongly influenced by choice of cleaning criterion. Because key policy and programming decisions depend on these statistics, variations in analytical practice could lead to inconsistent and potentially inappropriate implementation of malnutrition treatment programmes. We therefore call for mandatory reporting of cleaning criteria use so that results can be compared and interpreted appropriately. International consensus is urgently needed

  3. Prevalence of child malnutrition at a university hospital using the World Health Organization criteria and bioelectrical impedance data

    PubMed Central

    Pileggi, V.N.; Monteiro, J.P.; Margutti, A.V.B.; Camelo, J.S.

    2016-01-01

    Malnutrition constitutes a major public health concern worldwide and serves as an indicator of hospitalized patients’ prognosis. Although various methods with which to conduct nutritional assessments exist, large hospitals seldom employ them to diagnose malnutrition. The aim of this study was to understand the prevalence of child malnutrition at the University Hospital of the Ribeirão Preto Medical School, University of São, Brazil. A cross-sectional descriptive study was conducted to compare the nutritional status of 292 hospitalized children with that of a healthy control group (n=234). Information regarding patients’ weight, height, and bioelectrical impedance (i.e., bioelectrical impedance vector analysis) was obtained, and the phase angle was calculated. Using the World Health Organization (WHO) criteria, 35.27% of the patients presented with malnutrition; specifically, 16.10% had undernutrition and 19.17% were overweight. Classification according to the bioelectrical impedance results of nutritional status was more sensitive than the WHO criteria: of the 55.45% of patients with malnutrition, 51.25% exhibited undernutrition and 4.20% were overweight. After applying the WHO criteria in the unpaired control group (n=234), we observed that 100.00% of the subjects were eutrophic; however, 23.34% of the controls were malnourished according to impedance analysis. The phase angle was significantly lower in the hospitalized group than in the control group (P<0.05). Therefore, this study suggests that a protocol to obtain patients’ weight and height must be followed, and bioimpedance data must be examined upon hospital admission of all children. PMID:26840712

  4. Prevalence of child malnutrition at a university hospital using the World Health Organization criteria and bioelectrical impedance data.

    PubMed

    Pileggi, V N; Monteiro, J P; Margutti, A V B; Camelo, J S

    2016-03-01

    Malnutrition constitutes a major public health concern worldwide and serves as an indicator of hospitalized patients' prognosis. Although various methods with which to conduct nutritional assessments exist, large hospitals seldom employ them to diagnose malnutrition. The aim of this study was to understand the prevalence of child malnutrition at the University Hospital of the Ribeirão Preto Medical School, University of São, Brazil. A cross-sectional descriptive study was conducted to compare the nutritional status of 292 hospitalized children with that of a healthy control group (n=234). Information regarding patients' weight, height, and bioelectrical impedance (i.e., bioelectrical impedance vector analysis) was obtained, and the phase angle was calculated. Using the World Health Organization (WHO) criteria, 35.27% of the patients presented with malnutrition; specifically, 16.10% had undernutrition and 19.17% were overweight. Classification according to the bioelectrical impedance results of nutritional status was more sensitive than the WHO criteria: of the 55.45% of patients with malnutrition, 51.25% exhibited undernutrition and 4.20% were overweight. After applying the WHO criteria in the unpaired control group (n=234), we observed that 100.00% of the subjects were eutrophic; however, 23.34% of the controls were malnourished according to impedance analysis. The phase angle was significantly lower in the hospitalized group than in the control group (P<0.05). Therefore, this study suggests that a protocol to obtain patients' weight and height must be followed, and bioimpedance data must be examined upon hospital admission of all children. PMID:26840712

  5. Screening for malnutrition in patients with gastro-entero-pancreatic neuroendocrine tumours: a cross-sectional study

    PubMed Central

    Qureshi, Sheharyar A; Burch, Nicola; Druce, Maralyn; Hattersley, John G; Khan, Saboor; Gopalakrishnan, Kishore; Darby, Catherine; Wong, John L H; Davies, Louise; Fletcher, Simon; Shatwell, William; Sothi, Sharmila; Randeva, Harpal S; Dimitriadis, Georgios K; Weickert, Martin O

    2016-01-01

    Objectives To investigate whether screening for malnutrition using the validated malnutrition universal screening tool (MUST) identifies specific characteristics of patients at risk, in patients with gastro-entero-pancreatic neuroendocrine tumours (GEP-NET). Design Cross-sectional study. Setting University Hospitals Coventry & Warwickshire NHS Trust; European Neuroendocrine Tumour Society Centre of Excellence. Participants Patients with confirmed GEP-NET (n=161) of varying primary tumour sites, functioning status, grading, staging and treatment modalities. Main outcome measure To identify disease and treatment-related characteristics of patients with GEP-NET who score using MUST, and should be directed to detailed nutritional assessment. Results MUST score was positive (≥1) in 14% of outpatients with GEP-NET. MUST-positive patients had lower faecal elastase concentrations compared to MUST-negative patients (244±37 vs 383±20 µg/g stool; p=0.018), and were more likely to be on treatment with long-acting somatostatin analogues (65 vs 38%, p=0.021). MUST-positive patients were also more likely to have rectal or unknown primary NET, whereas, frequencies of other GEP-NET including pancreatic NET were comparable between MUST-positive and MUST-negative patients. Conclusions Given the frequency of patients identified at malnutrition risk using MUST in our relatively large and diverse GEP-NET cohort and the clinical implications of detecting malnutrition early, we recommend routine use of malnutrition screening in all patients with GEP-NET, and particularly in patients who are treated with long-acting somatostatin analogues. PMID:27147385

  6. The relationships between activation of non-specific inflammatory process and malnutrition in patients on peritoneal dialysis.

    PubMed

    Wójcik, Katarina; Stompór, Tomasz; Krzanowski, Marcin; Miarka, Przemysław; Zdzienicka, Anna; Sułowicz, Wladyslaw

    2007-01-01

    Malnutrition is a frequent complication among patients on chronic peritoneal dialysis and early recognition of malnutrition can be a key factor in successful treatment. The aim of the study was to assess the nutritional status of patients on peritoneal dialysis and to search for the relationships between activation of non-specific inflammatory process and progression of malnutrition. The study group included 60 patients (age 50.4+/-14 years) on peritoneal dialysis for 17.6+/-20 months. Fourty-six patients completed the entire 24-month observation period. Nutritional status was assessed using SGA scale, anthropometric measures, bioimpendance, and several biochemical parameters. Inflammatory markers included: IL-6, TNFalpha, fibrinogen and CRP. Severe malnutrition was observed in the range between 8.4% (5 subjects, group C in SGA scale) to 11.7% (7 subjects, BMI <20 kg/m2) of patients. The nutritional status of the entire cohort was constant over 2 years of observation (based on SGA scale), although the mean albumin level decreased significantly after 24 months of observation (from 39.55+/-3.5 to 37.63+/-3.7 g/l; p<0.01). The mean concentrations of CRP (4.8 and 5.25 mg/l), IL-6 (3.45 and 6.8 pg/ml) and leptin (22.95 and 22.2 ng/ml) were above reference ranges both at the initial and final assessment. Moreover, the concentration of IL-6 significantly increased (p<0.001) after 24 months of observation. Patients treated with PD are frequently affected by malnutrition. Our results indicate a strong association between nutritional indices and markers of inflammation. PMID:18928174

  7. Risk Factors for Malnutrition in Older Adults: A Systematic Review of the Literature Based on Longitudinal Data.

    PubMed

    Moreira, Nádia Cristina Fávaro; Krausch-Hofmann, Stefanie; Matthys, Christophe; Vereecken, Carine; Vanhauwaert, Erika; Declercq, Anja; Bekkering, Geertruida Elsiena; Duyck, Joke

    2016-05-01

    The present systematic review critically examines the available scientific literature on risk factors for malnutrition in the older population (aged ≥65 y). A systematic search was conducted in MEDLINE, reviewing reference lists from 2000 until March 2015. The 2499 papers identified were subjected to inclusion criteria that evaluated the study quality according to items from validated guidelines. Only papers that provided information on a variable's effect on the development of malnutrition, which requires longitudinal data, were included. A total of 6 longitudinal studies met the inclusion criteria and were included in the systematic review. These studies reported the following significant risk factors for malnutrition: age (OR: 1.038; P = 0.045), frailty in institutionalized persons (β: 0.22; P = 0.036), excessive polypharmacy (β: -0.62; P = 0.001), general health decline including physical function (OR: 1.793; P = 0.008), Parkinson disease (OR: 2.450; P = 0.047), constipation (OR: 2.490; P = 0.015), poor (OR: 3.30; P value not given) or moderate (β: -0.27; P = 0.016) self-reported health status, cognitive decline (OR: 1.844; P = 0.001), dementia (OR: 2.139; P = 0.001), eating dependencies (OR: 2.257; P = 0.001), loss of interest in life (β: -0.58; P = 0.017), poor appetite (β: -1.52; P = 0.000), basal oral dysphagia (OR: 2.72; P = 0.010), signs of impaired efficacy of swallowing (OR: 2.73; P = 0.015), and institutionalization (β: -1.89; P < 0.001). These risk factors for malnutrition in older adults may be considered by health care professionals when developing new integrated assessment instruments to identify older adults' risk of malnutrition and to support the development of preventive and treatment strategies. PMID:27184278

  8. BacMam-enabled LanthaScreen cellular assays for PI3K/Akt pathway compound profiling in disease-relevant cell backgrounds.

    PubMed

    Carlson, Coby B; Mashock, Michael J; Bi, Kun

    2010-03-01

    The authors recently reported the development and application of multiple LanthaScreen cellular assays to interrogate specific steps within the PI3K/Akt pathway. The importance of this signaling cascade in regulating fundamental aspects of cell growth and survival, as well as in the progression of cancer, underscores the need for portable cell-based assays for compound profiling in multiple disease-relevant cell backgrounds. To meet this need, the authors have now expanded their LanthaScreen assay platform across a variety of cell types using a gene delivery technology known as BacMam. Here, they have demonstrated the successful detection of Akt-dependent phosphorylation of PRAS40 at Thr246 in 10 different cell lines harboring mutations known to activate the PI3K/Akt pathway. In addition, they generated inhibitory profiles of 17 known pathway inhibitors in these same cells to validate the approach of using the BacMam-enabled LanthaScreen cellular assay format to rapidly profile compounds in disease-relevant cell types. Importantly, their results provide a broad illustration of how the genetic alterations that affect PI3K/Akt signaling can also influence the inhibitory profile of a given compound. PMID:20145103

  9. Acute Pancreatitis

    PubMed Central

    Geokas, Michael C.

    1972-01-01

    For many decades two types of acute pancreatitis have been recognized: the edematous or interstitial and the hemorrhagic or necrotic. In most cases acute pancreatitis is associated with alcoholism or biliary tract disease. Elevated serum or urinary α-amylase is the most important finding in diagnosis. The presence of methemalbumin in serum and in peritoneal or pleural fluid supports the diagnosis of the hemorrhagic form of the disease in patients with a history and enzyme studies suggestive of pancreatitis. There is no characteristic clinical picture in acute pancreatitis, and its complications are legion. Pancreatic pseudocyst is probably the most common and pancreatic abscess is the most serious complication. The pathogenetic principle is autodigestion, but the precise sequence of biochemical events is unclear, especially the mode of trypsinogen activation and the role of lysosomal hydrolases. A host of metabolic derangements have been identified in acute pancreatitis, involving lipid, glucose, calcium and magnesium metabolism and changes of the blood clotting mechanism, to name but a few. Medical treatment includes intestinal decompression, analgesics, correction of hypovolemia and other supportive and protective measures. Surgical exploration is advisable in selected cases, when the diagnosis is in doubt, and is considered imperative in the presence of certain complications, especially pancreatic abscess. PMID:4559467

  10. Pregnant Women's and Community Health Workers' Perceptions of Root Causes of Malnutrition Among Infants and Young Children in the Slums of Dhaka, Bangladesh

    PubMed Central

    Faiz, Sabina; Bogin, Barry A.; Griffiths, Paula L.

    2011-01-01

    Research in Bangladesh shows that malnutrition among infants and young children is most severe in urban slums. We examined the root causes of malnutrition as perceived by pregnant women and community health workers. We conducted 10 focus group discussions in the slums of Dhaka in 2008 and 2009. Participants accurately perceived inappropriate care, inappropriate environment, inappropriate food, and flooding to be major causes. Recurrent flooding has not traditionally been identified by experts as a cause of malnutrition. We recommend further research to address the nutritional risks flooding creates for vulnerable slum populations. PMID:21653248

  11. A case of anorexia nervosa with acute renal failure induced by rhabdomyolysis; possible involvement of hypophosphatemia or phosphate depletion.

    PubMed

    Wada, S; Nagase, T; Koike, Y; Kugai, N; Nagata, N

    1992-04-01

    A 16-year-old girl with anorexia nervosa first presented with malnutrition, liver dysfunction, and rhabdomyolysis. Administration of fluid and nutrition saved her from the initial critical state, but acute renal failure followed. Laboratory examination revealed intrinsic renal failure induced by rhabdomyolysis. Latent phosphate depletion and refeeding-induced hypophosphatemia was implicated as the cause of rhabdomyolysis; however coexisting hypotension, dehydration, and liver dysfunction may have contributed to the renal failure. The patient recovered from azotemia by hemodialysis. This is the first reported case of anorexia nervosa with acute renal failure resulting from rhabdomyolysis induced by hypophosphatemia or phosphate depletion. PMID:1633352

  12. Acute diarrhea.

    PubMed

    Barr, Wendy; Smith, Andrew

    2014-02-01

    Acute diarrhea in adults is a common problem encountered by family physicians. The most common etiology is viral gastroenteritis, a self-limited disease. Increases in travel, comorbidities, and foodborne illness lead to more bacteria-related cases of acute diarrhea. A history and physical examination evaluating for risk factors and signs of inflammatory diarrhea and/or severe dehydration can direct any needed testing and treatment. Most patients do not require laboratory workup, and routine stool cultures are not recommended. Treatment focuses on preventing and treating dehydration. Diagnostic investigation should be reserved for patients with severe dehydration or illness, persistent fever, bloody stool, or immunosuppression, and for cases of suspected nosocomial infection or outbreak. Oral rehydration therapy with early refeeding is the preferred treatment for dehydration. Antimotility agents should be avoided in patients with bloody diarrhea, but loperamide/simethicone may improve symptoms in patients with watery diarrhea. Probiotic use may shorten the duration of illness. When used appropriately, antibiotics are effective in the treatment of shigellosis, campylobacteriosis, Clostridium difficile, traveler's diarrhea, and protozoal infections. Prevention of acute diarrhea is promoted through adequate hand washing, safe food preparation, access to clean water, and vaccinations. PMID:24506120

  13. Sinusitis (acute)

    PubMed Central

    2008-01-01

    Introduction Acute sinusitis is defined pathologically, by transient inflammation of the mucosal lining of the paranasal sinuses lasting less than 4 weeks. Clinically, it is characterised by nasal congestion, rhinorrhoea, facial pain, hyposmia, sneezing, and, if more severe, additional malaise and fever. It affects 1−5% of the adult population each year in Europe. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments in people with clinically diagnosed acute sinusitis, and with radiologically or bacteriologically confirmed acute sinusitis? We searched: Medline, Embase, The Cochrane Library and other important databases up to August 2007 (BMJ Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 19 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: antibiotics (amoxicillin, co-amoxiclav, doxycycline, cephalosporins, macrolides, different doses [amoxicillin, co-amoxiclav, doxycycline, cephalosporins, macrolides], long-course regimens), antihistamines, cephalosporins or macrolides, decongestants (xylometazoline, phenylephrine, pseudoephedrine), doxycycline, saline nasal washes, steam inhalation, and topical corticosteroids (intra-nasal). PMID:19450327

  14. Sinusitis (acute)

    PubMed Central

    2011-01-01

    Introduction Acute sinusitis is defined pathologically, by transient inflammation of the mucosal lining of the paranasal sinuses lasting less than 4 weeks. Clinically, it is characterised by nasal congestion, rhinorrhoea, facial pain, hyposmia, sneezing, and, if more severe, additional malaise and fever. It affects 1% to 5% of the adult population each year in Europe. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments in people with clinically diagnosed acute sinusitis, and in people with radiologically or bacteriologically confirmed acute sinusitis? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2011 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 19 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: antibiotics (amoxicillin, amoxicillin–clavulanic acid [co-amoxiclav], doxycycline, cephalosporins, macrolides; different doses, long-course regimens), antihistamines, decongestants (xylometazoline, phenylephrine, pseudoephedrine), saline nasal washes, steam inhalation, and topical corticosteroids (intranasal). PMID:22189346

  15. Acute glomerulonephritis.

    PubMed

    Yoshizawa, N

    2000-09-01

    Acute glomerulonephritis (AGN) is a representative disease of acute nephritic syndrome characterized by the sudden appearance of edema, hematuria, proteinuria, and hypertension. The prototype of AGN is acute poststreptococcal glomerulonephritis (APSGN). "Nephritogenic streptococci" are defined as organisms that are cultured from a patient who develops AGN. Although only a limited number of M-types of streptococci have been recognized as "nephritogenic streptococci", all M-types of streptococci may have nephritogenic potential because the genes for major putative nephritogenic antigens such as SPEB and NAPIr are found to be present in all group A streptococci thus far examined. Pathogenic mechanisms for APSGN involving both humoral and cell-mediated immunity have been recently proposed. The role of humoral immunity is presumed to be mediated by the in situ formation of nephritogenic streptococcal antigen-antibody complexes and circulating immune complexes. While in the cellular immune component a role for delayed-type hypersensitivity has been suggested to contribute to the pathogenesis of APSGN. PMID:10969898

  16. A malnutrition-inflammation score is correlated with morbidity and mortality in maintenance hemodialysis patients.

    PubMed

    Kalantar-Zadeh, K; Kopple, J D; Block, G; Humphreys, M H

    2001-12-01

    Malnutrition inflammation complex syndrome (MICS) occurs commonly in maintenance hemodialysis (MHD) patients and may correlate with increased morbidity and mortality. An optimal, comprehensive, quantitative system that assesses MICS could be a useful measure of clinical status and may be a predictor of outcome in MHD patients. We therefore attempted to develop and validate such an instrument, comparing it with conventional measures of nutrition and inflammation, as well as prospective hospitalization and mortality. Using components of the conventional Subjective Global Assessment (SGA), a semiquantitative scale with three severity levels, the Dialysis Malnutrition Score (DMS), a fully quantitative scoring system consisting of 7 SGA components, with total score ranging between 7 (normal) and 35 (severely malnourished), was recently developed. To improve the DMS, we added three new elements to the 7 DMS components: body mass index, serum albumin level, and total iron-binding capacity to represent serum transferrin level. This new comprehensive Malnutrition-Inflammation Score (MIS) has 10 components, each with four levels of severity, from 0 (normal) to 3 (very severe). The sum of all 10 MIS components ranges from 0 to 30, denoting increasing degree of severity. These scores were compared with anthropometric measurements, near-infrared-measured body fat percentage, laboratory measures that included serum C-reactive protein (CRP), and 12-month prospective hospitalization and mortality rates. Eighty-three outpatients (44 men, 39 women; age, 59 +/- 15 years) on MHD therapy for at least 3 months (43 +/- 33 months) were evaluated at the beginning of this study and followed up for 1 year. The SGA, DMS, and MIS were assessed simultaneously on all patients by a trained physician. Case-mix-adjusted correlation coefficients for the MIS were significant for hospitalization days (r = 0.45; P < 0.001) and frequency of hospitalization (r = 0.46; P < 0.001). Compared with the SGA

  17. Preventing Malnutrition in Post-Conflict, Food Insecure Settings: A Case Study from South Sudan

    PubMed Central

    Paul, Amy; Doocy, Shannon; Tappis, Hannah; Funna Evelyn, Sonya

    2014-01-01

    Background: Decades of civil conflict compound the challenges of food insecurity in South Sudan and contribute to persistent, high levels of child malnutrition. As efforts to prevent child malnutrition continue, there is a critical need for strategies that effectively supplement the diets of pregnant women and young children in transitional, highly food insecure settings like South Sudan. Methods: This mixed-methods case study of four communities in South Sudan reports on the diets of children under 2 years of age and explores household-level factors including household size, intrahousehold food allocation practices, and responses to scarcity that may have significant impact on the effectiveness of strategies relying on household ration distribution to supplement the diets of pregnant women and children under 2 years of age. Results: Participants reported experiencing increased scarcity as a result of prolonged drought and household sizes enlarged by the high volume of returning refugees. Although communities were receiving monthly household rations through a non-emergency food assistance program, most households had exhausted rations less than 30 days after receipt. Results showed that more than one half of children 12-17 months and one third of children 18-23 months consumed diets consisting of fewer than 4 food groups in the last week. Intrahousehold food allocation patterns give children first priority at meal times even in times of scarcity, yet adult women, including pregnant women, have last priority. Discussion: These findings suggest that distribution of supplementary household rations will likely be insufficient to effectively supplement the diets of young children and pregnant women in particular. In light of the multiple contextual challenges experienced by households in transitional, food-insecure settings, these findings support recommendations to take a context-specific approach to food assistance programming, in which considerations of

  18. Determinants of Child Malnutrition and Infant and Young Child Feeding Approaches in Cambodia.

    PubMed

    Reinbott, Anika; Jordan, Irmgard

    2016-01-01

    Women's diets often decrease with regard to amounts per meal and day as well as diversity if a household's access to food is limited. The result is a monotonous diet that, in particular, negatively affects women's nutritional status during pregnancy and lactation and, thus, the infant. The infant's diet is of utmost importance, as it needs to meet the nutrient requirements especially during the first 2 years of life, a critical window for the child's healthy development. In Cambodia, infant and young child feeding (IYCF) practices are poor. Preparation of a special complementary meal in addition to breast milk feeds for children aged 6-23 months is often not a common habit. Instead, children eat watery, plain rice porridges that do not meet the nutrient requirements at this young age. A lack of adequate caring practices such as responsive feeding exacerbates the risk of malnutrition. Caregivers are often unaware of the importance of nutrition during the first 2 years of life regarding its effects on children's growth. In 2012, a randomized controlled trial (RCT) was started in two provinces of northern Cambodia: Oddar Meanchey and Preah Vihear. To contribute to reducing child mortality by addressing malnutrition among children 6-23 months of age, the Food and Agriculture Organization of the United Nations (FAO) implemented a nutrition-sensitive agriculture project with nutrition-specific actions, i.e. a nutrition education intervention was embedded in a food security project. Wealth, a child's age, and maternal education were identified as determinants of a child's dietary diversity. The older the child and/or the wealthier the household, the more diverse the child's diet. Maternal education was positively associated with the child's dietary diversity. Household dietary diversity was significantly associated with child dietary diversity in a model including group, child's age, maternal education, and wealth as confounders. The RCT also showed that a 2- to 3-month

  19. Protein malnutrition up-regulates growth hormone receptor expression in rat splenic B lymphocytes.

    PubMed

    Mejía-Naranjo, Wilson; Sánchez-Gomez, Myriam

    2004-12-01

    The reciprocal interaction between the endocrine and immune systems has been the subject of active research during the last decade, and an important body of evidence has accumulated supporting the role of the GH/IGF axis in immune function. More recently, the GH/IGF axis has been postulated as playing an important role in the modulation of stress conditions, such as catabolic stages, aging-related disorders, immunodeficient aids patients and malnutrition. Whether these effects are exerted through endocrine, autocrine or paracrine mechanisms remains to be determined for different immune cell types and tissues. The aim of the current study was to define which specific subsets of lymphocytes are the primary targets for GH action. In addition, the regulatory role of stress induced by protein restriction was investigated with respect to the relative distribution of GH receptor positive lymphoid cells. Normal growing rats were fed isocaloric diets with variable protein content (0, 4, 8, 12 and 20%) for a period of 14 days. The lymphoid cells were then separated from spleen, lymph nodes and peripheral blood lymphocytes. Flow cytometry analysis measured the binding characteristics of Fluos-rrGH to lymphocytes together with specific PE-labelled mAbs defining CD4+ and CD8+ T cells and B lymphocytes. The pattern of expression of the GH receptor differed among the lymphoid tissues and cell subsets. Spleen was the most responsive organ to protein deprivation with highest GH receptor expression in B lymphocytes, followed by CD4+ T cells. As the protein intake was decreased from 20% to 0%, the percentage of GHR positive cells increased from 12% to 52% in splenic B lymphocytes and from 8% to 17% in CD4+ T cells. In contrast, only 10%-13% of lymphocytes in lymph nodes and 2%-4% in circulation, showed binding sites to GH associated with protein deprivation. In conclusion, the increase in GH receptors on lymphocytes under catabolic stress induced by protein malnutrition gives support

  20. Is the adult protein-energy malnutrition syndrome the same as that described in the infant?

    PubMed

    Mauron, J; Antener, I

    1983-01-01

    Protein-energy malnutrition, a multi-factorial disease, has been described predominantly in the infant. It was the aim of this research to give a biochemical assessment of the adult form and to compare it to the infantile syndrome within the same socio-cultural context of central Zaïre (Kwilu region). Thirty-four children, 22 women and 2 men suffering from marasmic kwashiorkor at the hospital of Yasa-Bonga (Kwilu) were submitted to a complete set of 7 anthropometric and 60 biochemical tests. The control values were taken from healthy well-fed children and adults from Yasa-Bonga; for certain parameters, rural adult control values were also obtained. Dyspigmentation was found in all patients, children and adults alike. The other symptoms were, in decreasing order of importance : oedema, dermatitis, apathy and liver enlargement, often accompanied by associated secondary pathology. In the children, all anthropometric indices were well below normal. In serum, total protein, albumin, prealbumin, ceruloplasmin and haemoglobin were reduced; the alpha 1, alpha 2 and beta-globulins were slightly reduced in infants but not much modified in adults, whereas gamma-globulins were slightly increased in adults only. IgG and IgM were increased in both infants and adults, the enhancement was less pronounced for IgA. Essential amino acids in serum were reduced in the patients and most non-essential amino acids raised, with the exception of tyrosine and arginine which were reduced like the essential amino acids. Some ratios (phenylalanine/tyrosine, serine/threonine, and non-essential/essential amino acids) proved to be very sensitive parameters for this type of protein-energy malnutrition. No differences were found in the amino acid levels between adult and infant patients, with the exception of alanine which was higher in the adults. Alanine levels were also high in the rural adult controls as compared to the European controls, probably due to the extremely high carbohydrate (manioc

  1. Effects of randomized supplementation of methionine or alanine on cysteine and glutathione production during the early phase of treatment of children with edematous malnutrition123

    PubMed Central

    Green, Curtis O; Hsu, Jean W; Taylor-Bryan, Carolyn; Reid, Marvin; Forrester, Terrence; Jahoor, Farook

    2014-01-01

    Background: We have shown that a low glutathione concentration and synthesis rate in erythrocytes are associated with a shortage of protein-derived cysteine in children with edematous severe acute malnutrition (SAM). Objective: We tested the hypothesis that methionine supplementation may increase protein-derived cysteine and upregulate cysteine synthesis, thereby improving glutathione synthesis during the early treatment of edematous SAM. Design: The cysteine flux, its de novo synthesis and release from protein breakdown, and erythrocyte glutathione synthesis rate were measured in 12 children with edematous SAM in the fed state by using stable isotope tracers at 3 clinical phases as follows: 3 ± 1 d (±SE) [clinical phase 1 (CP1)], 8 ± 1 d [clinical phase 2 (CP2)], and 14 ± 2 d (clinical phase 3) after admission. Subjects were randomly assigned to receive equimolar supplements (0.5 mmol ⋅ kg−1 ⋅ d−1) of methionine or alanine (control) immediately after CP1. Results: In the methionine compared with the alanine group, cysteine flux derived from protein breakdown was faster at CP2 than CP1 (P < 0.05), and the change in plasma cysteine concentration from CP1 to CP2 was greater (P < 0.05). However, there was no evidence of a difference in cysteine de novo synthesis and its total flux or erythrocyte glutathione synthesis rate and concentration between groups. Conclusions: Methionine supplementation increased cysteine flux from body protein but had no significant effect on glutathione synthesis rates. Although cysteine is made from methionine, increased dietary cysteine may be necessary to partially fulfill its demand in edematous SAM because glutathione synthesis rates and concentrations were less than previous values shown at full recovery. This study was registered at clinicaltrials.gov as NCT00473031. PMID:24598154

  2. Nutritional risk, malnutrition and nutritional support among hospitalized patients in orthopedics/spinal surgery of a Hohhot teaching hospital.

    PubMed

    Wang, Nannan; Dong, Yalin; Huo, Ting; Shao, Yanqing; Xing, Wenhua; Li, Shuwen

    2016-01-01

    The evolution of nutritional status (the prevalence of nutritional risk, malnutrition, overweight and obesity) and the nutritional support of the hospitalized patients from admission to discharge or over a two-week period in orthopedics/ spinal surgery of a teaching hospital in Hohhot were investigated. 432 patients from two wards of the orthopedics/spinal surgery from Jan to Dec 2013, the traditional spinal surgery and the minimally invasive spinal surgery, were selected and detected in this study. The Nutritional Risk Score 2002 (NRS 2002) was used to determine the patients' nutritional status within 48 h after admission and during their hospitalization. The overall prevalence of nutritional risk, malnutrition, overweight and obesity at admission was 11.6%, 12.7%, 35.9% and 7.41%, respectively. Overall, there were 88.0% of the patients who were at nutritional risk received nutritional support, while 14.1% of non-risk patients received a redundant nutritional support. The overall prevalence of nutritional risk changed from 11.6% at admission to 19.4% upon discharge (p<0.05), and the prevalence of malnutrition changed from 12.7% to 20.6% (p<0.05). The prevalence of overweight and obesity, which changed from 35.9% to 31.0% and from 7.41% to 5.79% respectively, didn't experience statistically significant evolution. NRS 2002 was a feasible nutritional risk screening tool for patients in spinal surgery of orthopedics department. Patients' prevalence of nutritional risk and malnutrition increased significantly in spinal surgery of this hospital. Some inappropriate uses of nutritional support were observed in orthopedics/spinal surgery, and nutritional support guidelines or protocols should be promoted by a professional committee. PMID:27222410

  3. BacMam Virus Transduced Cardiomyoblasts Can Be Used for Myocardial Transplantation Using AP-PEG-A Microcapsules: Molecular Cloning, Preparation, and In Vitro Analysis

    PubMed Central

    Paul, Arghya; Khan, Afshan Afsar; Shum-Tim, Dominique; Prakash, Satya

    2010-01-01

    The potential of genetically modified cardiomyoblasts in treating damaged myocardium is well known. However, efficient delivery of these cells is of major concern during treatment. The limiting factors are the massive cell death that occurs soon after their intramyocardial transplantation into the beating heart. To address these problems, we generated recombinant baculoviruses (BacMam viruses) which efficiently transduced cardiomyoblast cells under optimized conditions. These genetically modified cells were then protected in a new polymeric microcapsule using poly-ethylene-glycol (PEG), alginate, and poly-L-lysine (PLL) polymers for efficient delivery. Results showed that microcapsules maintain cell viability and support cell proliferation for at least 30 days. The capsules exhibit strong immunoprotective potential and have high mechanical and osmotic stability with more than 70% intact capsules. The encased transduced cells showed a rapid transgene expression inside the capsule for at least 15 days. However, preclinical studies are needed to further explore its long-term functional benefits. PMID:21331169

  4. BacMam virus transduced cardiomyoblasts can be used for myocardial transplantation using AP-PEG-A microcapsules: molecular cloning, preparation, and in vitro analysis.

    PubMed

    Paul, Arghya; Khan, Afshan Afsar; Shum-Tim, Dominique; Prakash, Satya

    2010-01-01

    The potential of genetically modified cardiomyoblasts in treating damaged myocardium is well known. However, efficient delivery of these cells is of major concern during treatment. The limiting factors are the massive cell death that occurs soon after their intramyocardial transplantation into the beating heart. To address these problems, we generated recombinant baculoviruses (BacMam viruses) which efficiently transduced cardiomyoblast cells under optimized conditions. These genetically modified cells were then protected in a new polymeric microcapsule using poly-ethylene-glycol (PEG), alginate, and poly-L-lysine (PLL) polymers for efficient delivery. Results showed that microcapsules maintain cell viability and support cell proliferation for at least 30 days. The capsules exhibit strong immunoprotective potential and have high mechanical and osmotic stability with more than 70% intact capsules. The encased transduced cells showed a rapid transgene expression inside the capsule for at least 15 days. However, preclinical studies are needed to further explore its long-term functional benefits. PMID:21331169

  5. Managing Malnutrition in Older Persons Residing in Care Homes: Nutritional and Clinical Outcomes Following a Screening and Intervention Program.

    PubMed

    Mountford, Christopher G; Okonkwo, Arthur C O; Hart, Kathryn; Thompson, Nick P

    2016-01-01

    This study aimed to establish prevalence of malnutrition in older adult care home residents and investigate whether a nutritional screening and intervention program could improve nutritional and clinical outcomes. A community-based cohort study was conducted in five Newcastle care homes. 205 participants entered; 175 were followed up. Residents already taking oral nutritional supplements (ONS) were excluded from interventions. Those with Malnutrition Universal Screening Tool (MUST) score of 1 received dietetic advice and ≥2 received dietetic advice and were prescribed ONS (220 ml, 1.5 kcal/ml) twice daily for 12 weeks. Body mass index (BMI), MUST, mini nutritional assessment score (MNA)®, mid upper arm muscle circumference (MAMC), and Geriatric Depression Scale (GDS) were recorded at baseline and 12 weeks. Malnutrition prevalence was 36.6% ± 6.6 (95% CI). A higher MUST was associated with greater mortality (p = 0.004). Type of intervention received was significantly associated with change in MUST score (p < 0.001); dietetic advice resulting in the greatest improvement. There were no significant changes in BMI (p = 0.445), MAMC (p = 0.256), or GDS (p = 0.385) following the interventions. Dietitian advice may slow the progression of nutritional decline. In this study oral nutritional supplements over a 3-month period did not significantly improve nutritional status in malnourished care home residents. PMID:26885946

  6. Impaired IQ and Academic Skills in Adults Who Experienced Moderate to Severe Infantile Malnutrition: A Forty-Year Study

    PubMed Central

    Waber, Deborah P.; Bryce, Cyralene P.; Girard, Jonathan M.; Zichlin, Miriam; Fitzmaurice, Garrett M.; Galler, Janina R.

    2013-01-01

    Objectives To evaluate IQ and academic skills in adults who experienced an episode of moderate to severe infantile malnutrition and a healthy control group, all followed since childhood in the Barbados Nutrition Study. Methods IQ and academic skills were assessed in 77 previously malnourished adults (mean age=38.4 years; 53% male) and 59 controls (mean age=38.1 years; 54% male). Group comparisons were carried out by multiple regression and logistic regression, adjusted for childhood socioeconomic factors. Results The previously malnourished group showed substantial deficits on all outcomes relative to healthy controls (p<0.0001). IQ scores in the Intellectual Disability range (< 70) were 9 times more prevalent in the previously malnourished group (OR=9.18; 95% CI=3.50-24.13). Group differences in IQ of approximately one standard deviation were stable from adolescence through mid-life. Discussion Moderate to severe malnutrition during infancy is associated with a significantly elevated incidence of impaired IQ in adulthood, even when physical growth is completely rehabilitated. An episode of malnutrition during the first year of life carries risk for significant lifelong functional morbidity. PMID:23484464

  7. Maternal Malnutrition in the Etiopathogenesis of Psychiatric Diseases: Role of Polyunsaturated Fatty Acids.

    PubMed

    Morgese, Maria Grazia; Trabace, Luigia

    2016-01-01

    Evidence from human studies indicates that maternal metabolic state and malnutrition dramatically influence the risk for developing psychiatric complications in later adulthood. In this regard, the central role of polyunsaturated fatty acids (PUFAs), and particularly n-3 PUFAs, is emerging considering that epidemiological evidences have established a negative correlation between n-3 PUFA consumption and development of mood disorders. These findings were supported by clinical studies indicating that low content of n-3 PUFAs in diet is linked to an increased susceptibility to psychiatric disorders. PUFAs regulate membrane fluidity and exert their central action by modulating synaptogenesis and neurotrophic factor expression, neurogenesis, and neurotransmission. Moreover, they are precursors of molecules implicated in modulating immune and inflammatory processes in the brain. Importantly, their tissue concentrations are closely related to diet intake, especially to maternal consumption during embryonal life, considering that their synthesis from essential precursors has been shown to be inefficient in mammals. The scope of this review is to highlight the possible mechanisms of PUFA functions in the brain during pre- and post-natal period and to evaluate their role in the pathogenesis of psychiatric diseases. PMID:27472366

  8. CINI's approaches to intervention: an innovative strategy to combat malnutrition in India.

    PubMed

    Chaudhuri, S N

    2002-05-01

    The Child in Need Institute (CINI) has been working toward sustainable health and nutrition development for women and children for the last twenty-six years. During the initial stages, the Institute focused on treatment and prevention of malnutrition in children under five years of age. Over the years, the program strategies have shifted to a more holistic lifecycle approach. This approach targets individuals during crucial periods of their lives--pregnant women, children (0-2 years of age) and adolescents (10-19 years of age)--as well as other vulnerable segments of the population. To reach out to these target groups, the Institute uses a three-pronged strategy that includes case management, behavior change communication, and linkage formation. Programs are either community- or center-based depending upon the need of the populations. CINI's current strategy has shown positive trends in improving the health and nutrition status of women, children, and adolescents in the community. Results include reduction of low birth weight babies, increase in proper antenatal care, reduction of severely malnourished children, decrease in maternal and infant mortality and morbidity rates, and improvement in community involvement in all reproductive and child health programs. CINI is currently monitoring its performance and activities to carry out operations research for providing further evidence for the effectiveness of its interventions. PMID:12035846

  9. Malnutrition in emergencies: how can we do better and where do the responsibilities lie?

    PubMed

    Seaman, J

    1999-12-01

    Over many years, the international relief system has been repeatedly criticised in terms of slowness of response, poor inter-agency co-ordination, and technical incompetence on a larger or smaller scale. Notwithstanding many initiatives to improve co-ordination and other aspects of international relief performance, relief failures, including epidemic malnutrition, continue to occur. The reasons for these failures are discussed from the perspective of the characteristics of the international system, and the way in which this would be expected to perform under different conditions. The chief limitations of the international system identified are: the lack of any focus for imposing co-ordination, other than governments of affected countries; the lack of any requirement for donor nations to ensure that adequate resources are supplied; and a tendency for the system to respond uncritically to the international media. A broad typology of international responses is proposed. It is suggested that relief failure can be recast in terms of the lack of any system which can ensure the correct allocation of food and other resources between emergencies, and ensure the systematic distribution of such resources as are supplied. It concludes that the scope for further improvement in the performance of the international relief system is now limited, but that the most promising area for investment would, where possible, support governments in affected countries to take greater control of the management of the international relief system. PMID:10643107

  10. Feeding patterns of children with protein-energy malnutrition in Nigeria.

    PubMed

    Jinadu, M K; Ojofeitimi, E O; Osifor, E O

    1986-04-01

    Feeding patterns of 115 cases of children suffering from protein-energy malnutrition (PEM) were investigated to determine the feeding patterns and practices of children who succumb to PEM. The study was conducted at the Ile-Ife University Teaching Hospital in Nigeria between December, 1978 and May, 1979. 3 main clinical symptoms associated with PEM are Kwashiorkor, marasmus, and undernutrition. A questionnaire was given to mothers to record area of residence, age and sex of child, occupation and education level of parents, and mothers' feeding practices (breastfeeding, use of artificial milk, food taboos.) Tables present data on social characteristics of parents and age and sex distribution of malnourished children. 30.4% of mothers stopped breastfeeding before children were 1 year old, and 69.5% stopped before 17 months. 91.3% of the children were introduced to corn pap, a gruel made from corn, before they were 6 months, and were fed exclusively on it until after 12 months. 83.5% of mothers believed that meat and fish would cause intestinal worms and stomach pains, and 69.6% believed eggs would make a child steal. Mean age of onset of Kwashiorkor was 27 months. With appropriate nutritional health education and practical demonstrations, parents beliefs about food might be changed, possibly by reaching families through home visiting by community health workers. PMID:3094212

  11. Modeling historical tuberculosis epidemics among Canadian First Nations: effects of malnutrition and genetic variation

    PubMed Central

    Ackley, Sarah F.; Liu, Fengchen; Porco, Travis C.

    2015-01-01

    Late 19th century epidemics of tuberculosis (TB) in Western Canadian First Nations resulted in peak TB mortality rates more than six times the highest rates recorded in Europe. Using a mathematical modeling approach and historical TB mortality time series, we investigate potential causes of high TB mortality and rapid epidemic decline in First Nations from 1885 to 1940. We explore two potential causes of dramatic epidemic dynamics observed in this setting: first, we explore effects of famine prior to 1900 on both TB and population dynamics. Malnutrition is recognized as an individual-level risk factor for TB progression and mortality; its population-level effects on TB epidemics have not been explored previously. Second, we explore effects of heterogeneity in susceptibility to TB in two ways: modeling heterogeneity in susceptibility to infection, and heterogeneity in risk of developing disease once infected. Our results indicate that models lacking famine-related changes in TB parameters or heterogeneity result in an implausibly poor fit to both the TB mortality time series and census data; the inclusion of these features allows for the characteristic decline and rise in population observed in First Nations during this time period and confers improved fits to TB mortality data. PMID:26421237

  12. The view of European experts regarding health economics for medical nutrition in disease-related malnutrition.

    PubMed

    Freijer, K; Lenoir-Wijnkoop, I; Russell, C A; Koopmanschap, M A; Kruizenga, H M; Lhachimi, S K; Norman, K; Nuijten, M J C; Schols, J M G A

    2015-05-01

    Health-care systems are currently facing tremendous budget constraints resulting in growing pressure on decision makers and health-care providers to obtain the maximum possible health benefits of the resources available. Choices have to be made, and health economics can help in allocating limited health-care resources among unlimited wants and needs. Attempts to achieve cost reductions often focus on severe pathologies and chronic diseases as they commonly represent high health-care expenditures. In this context, awareness of the considerable financial burden caused by disease-related malnutrition (DRM) is lacking. Possibilities of reducing costs by optimising the management of DRM through medical nutrition will mostly not even be taken into account. During a European expert meeting, the total evaluation of medical nutrition was viewed and discussed. The aim of this meeting was to gain an experts' outline of the key issues relating to the health economic assessment of the use of medical nutrition. This article provides a summary of the observations per discussed item and describes the next steps suggested. PMID:25604774

  13. The effects of population density and malnutrition on the dynamics of whooping cough.

    PubMed Central

    Duncan, C. J.; Duncan, S. R.; Scott, S.

    1998-01-01

    Liverpool, a seaport in NW England, suffered severely from lethal infectious diseases in the second half of the 19th century: the population was densely crowded and malnourished and life expectancy was low. Time-series analysis shows that the epidemics of whooping cough (i) had an interepidemic interval of 2.9 years, 1863-85, which lengthened to 3.4 years, 1885-1900 (ii) were strongly coherent with wheat prices (P < 0.001) and (iii) also correlated with cycles of seasonal weather conditions. It is suggested from mathematical modelling that the epidemics in this compromised population were maintained (i.e. the system was driven) by an oscillation of malnutrition and by seasonal weather conditions. A model that incorporates both the dynamics of whooping cough and the demographic characteristics of the population is presented. It has been shown to replicate the dynamics of the epidemics and has been used to predict the changes with time of (i) the force of the infection and (ii) the proportion of those infected with whooping cough who died. PMID:9825783

  14. Accuracy and limitations of the diagnosis of malnutrition in dialysis patients.

    PubMed

    Kovesdy, Csaba P; Kalantar-Zadeh, Kamyar

    2012-07-01

    Uremic malnutrition, also known as protein-energy wasting (PEW), is a common phenomenon in maintenance dialysis patients and a risk factor for poor clinical outcomes including worse quality of life and increased hospitalization and mortality. The paradoxical association between traditional cardiovascular risk factors and better outcomes in dialysis patients also referred to as "reverse epidemiology," is a good example of the powerful effect-modifying impact of the nutritional status in this population. Measures of food intake, body composition tools, nutritional scoring systems, and laboratory values such as serum albumin are used to diagnose PEW and to assess the degree of severity of PEW without clearly validated diagnostic criteria. Some observational studies suggest that inflammation is a missing link between the PEW and poor clinical outcomes in dialysis patients, although PEW per se may also predispose to illness and inflammation. Ongoing debate as to whether such surrogates as serum albumin or prealbumin concentrations are markers of nutritional status, inflammation, comorbidity, or other conditions has led to confusion and diagnostic and therapeutic nihilism. Irrespective of the cause of hypoalbuminemia in dialysis patients, evidence suggests that nutritional interventions can increase serum albumin in dialysis patients. Hence, we should continue assessing serum albumin and other surrogates of nutritional status to risk-stratify patients and to allocate nutritional therapy, while well-designed, large-scale, randomized, controlled trials of the effects of nutritional intake on clinical outcomes are awaited. PMID:22731746

  15. Hypoalbuminemia and Malnutrition Associated With Cow’s Milk Allergy: A Case Report

    PubMed Central

    Altinel Acoglu, Esma; Akcaboy, Meltem; Melek Oguz, Melahat; Kilic, Mustafa; Zorlu, Pelin; Senel, Saliha

    2016-01-01

    Introduction Cow’s milk allergy is the most common food allergy in children. Symptoms usually involve the skin and the gastrointestinal and respiratory tracts. Gastrointestinal tract manifestations of cow’s milk allergy are nonspecific, and are the only type that can be diagnosed in all age groups. Here, we report a rare case of cow's milk allergy in an infant with hypoalbuminemia and malnutrition. Case Presentation A nine-month-old girl was admitted to Dr. Sami Ulus maternity and children’s health and diseases training and research hospital, Ankara, Turkey, in September 2013, for weakness and swelling of the legs that had endured for two days. She had bilateral pretibial pitting (+2) edema. Laboratory data revealed albumin at 1.7 g/dL; serum Na, K, urea, creatinin, and alanine-aspartate aminotransferase levels were normal. Her urinary analysis did not reveal proteinuria. Stool samples were normal, and stool steatocrite was negative. Anti-gliadin, anti-endomysium, and anti-tissue transglutaminase antibodies were negative. Cow’s milk allergy was diagnosed due to cow’s milk-specific IgE and skin prick test results. Conclusions On rare occasions, cow’s milk allergy presents with hypoalbuminemia. When diagnosis is delayed, this allergy may impair the growth and quality of life and may even be life-threatening. PMID:27621935

  16. Combating protein-energy-malnutrition in a rural/peri-urban southern African black population.

    PubMed

    MacIntyre, U E; Bac, M; Kuzwayo, P M; Glatthaar, I I; Ingle, R F; Walker, A R

    1991-10-01

    PROTEIN-ENERGY-malnutrition (PEM) is a major cause of morbidity and mortality in young children in Africa. In South Africa, in 1987, to help combating and preventing PEM in the rural black population, the Gold Fields Nutrition Unit was inaugurated at the Medical University of Southern Africa. In 1987-9, 442 patients (rural/peri-urban) plus their mothers or child carers were admitted, and 406 attended as outpatients. Average age was 15.4 +/- 7.6 months, weight 7.0 +/- 1.6kg, stay in hospital, 12 +/- 10.8 days, and daily weight gain during treatment was 31 +/- 48g. Mothers mainly were young and unmarried. Primary causative factors were infections, ignorance, and insufficiency of food. Since results from rehabilitation are usually poor, mothers and carers were taught how best to prepare meals using local foodstuffs. The interventions included teaching and demonstrations of how to grow vegetables, maintain an orchard, a fowl-run, and improve kitchen and laundry facilities. In 1990, in a follow-up of 73 patients, no deaths had occurred within a 12 month period. This far better than usual outcome is being furthered by setting up satellite nutrition clinics. PMID:1795353

  17. [Acute myocarditis].

    PubMed

    Combes, Alain

    2012-06-01

    Myocarditis is defined as inflammation of the myocardium accompanied by myocellular necrosis. Acute myocarditis must be considered in patients who present with recent-onset of cardiac failure or arrhythmia. Fulminant myocarditis is a distinct entity characterized by sudden onset of severe congestive heart failure or cardiogenic shock, usually following a flu-like illness, parvovirus B19, human herpesvirus 6, coxsackievirus and adenovirus being the most frequently viruses responsible for the disease. Treatment of myocarditis remains largely supportive, since immunosuppression has not been proven to be beneficial for acute lymphocytic myocarditis. Trials of antiviral therapies, or immunostimulants such as interferons, suggest a potential therapeutic role but require further investigation. Lastly, early recognition of patients rapidly progressing to refractory cardiac failure and their immediate transfer to a medical-surgical center experienced in mechanical circulatory support is warranted. In this setting, ECMO should be the first-line mechanical assistance. For highly unstable patients, a Mobile Cardiac Assistance Unit, that rapidly travels to primary care hospitals with a portable ECMO system and hooks it up before refractory multiorgan failure takes hold, is the preferred option. PMID:22515999

  18. [Acute myocarditis].

    PubMed

    Combes, Alain

    2013-05-01

    Myocarditis is defined as inflammation of the myocardium accompanied by myocellular necrosis. Acute myocarditis must be considered in patients who present with recent onset of cardiac failure or arrhythmia. Fulminant myocarditis is a distinct entity characterized by sudden onset of severe congestive heart failure or cardiogenic shock, usually following a flu-like illness, parvovirus B19, human herpesvirus 6, coxsackievirus and adenovirus being the most frequently viruses responsible for the disease. Treatment of myocarditis remains largely supportive, since immunosuppression has not been proven to be beneficial for acute lymphocytic myocarditis. Trials of antiviral therapies, or immunostimulants such as interferons, suggest a potential therapeutic role but require further investigation. Lastly, early recognition of patients rapidly progressing to refractory cardiac failure and their immediate transfer to a medical-surgical center experienced in mechanical circulatory support is warranted. In this setting, ECMO should be the first-line mechanical assistance. For highly unstable patients, a Mobile Cardiac Assistance Unit, that rapidly travels to primary care hospitals with a portable ECMO system and hooks it up before refractory multiorgan failure takes hold, is the preferred option. PMID:23789482

  19. [Local food mixtures for the treatment of protein-calorie malnutrition in the Mondongo, Zaire rural health center].

    PubMed

    Kalissa, V; Monziba, B

    1993-01-01

    Protein-calorie malnutrition is found in environments characterized by ignorance, illiteracy, poverty, poor hygiene, and absence of food processing industries. At the Mondongo rural health center in Zaire, malnourished children are not rare, although they live in an environment rich in the foods necessary for growth and development. Parents are poorly informed about the desirable age at weaning, the nutritional requirements of weaned infants, and appropriate diet and food preparation for weaned children. The income of local residents does not permit purchase of imported foods. Children must thus be nourished with local foods. Manifestations of protein-calorie malnutrition range from slight retardation of growth to serious disease, including marasmus and kwashiorkor. Among 337 children studied in Mondongo, 66 (19.5%) were seriously malnourished, with upper arm circumferences of less than 13 cm, or weight being 60% of normal weight for their age. 81 children (21%) had moderate malnutrition, with are circumferences of barely 15 cm, or weight for age 60-80% of normal. 190 children were adequately nourished, with arm circumferences of at least 16 cm and weight over 80% of normal for their age. The most frequent consumed foods in Mondongo are manioc, rice, plantains, maize, peanuts eaten as snacks between meals, soybeans (still in the stage of introduction and not well accepted), fruits, palm oil, and some vegetables. Chicken and eggs are widely consumed. There are not dishes especially prepared for newly weaned children. A formula for a weaning food called Mariso proposed by a group of researchers in 1984 was found to be poorly accepted because it included soybeans, which are not widely available or well accepted. Two mixtures more appropriate to local realities were developed. Mariche combines maize, rice, and locally harvested and smoked caterpillars, while mariop combines maize, rice, and eggs. The mixtures can be stored for short periods in ordinary containers in a

  20. Acute cerebellar ataxia

    MedlinePlus

    Cerebellar ataxia; Ataxia - acute cerebellar; Cerebellitis; Post-varicella acute cerebellar ataxia; PVACA ... Acute cerebellar ataxia in children, especially younger than age 3, may occur several weeks after an illness caused by a virus. ...

  1. Ear infection - acute

    MedlinePlus

    Otitis media - acute; Infection - inner ear; Middle ear infection - acute ... Casselbrandt ML, Mandel EM. Acute otitis media and otitis media with effusion. In: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Head & Neck Surgery . 6th ed. ...

  2. Management of acute diarrhea in emergency room.

    PubMed

    Dekate, Parag; Jayashree, M; Singhi, Sunit C

    2013-03-01

    Acute diarrhea is the second leading cause of under-five mortality in India. It is defined as the passage of frequent watery stools (>3/24 h). Recent change in consistency of stools is more important than frequency. Acute diarrhea is caused by variety of viral, bacterial and parasitic agents. The common ones are: Rotavirus, E. coli, Shigella, Cholera, and Salmonella. Campylobacter jejuni, Giardia and E. histolytica are also not uncommon. The most important concern in management of acute diarrhea in Emergency room (ER) is fluid and electrolyte imbalances and treatment of underlying infection, wherever applicable. It includes, initial stabilization (identification and treatment of shock), assessment of hydration and rehydration therapy, recognition and treatment of electrolyte imbalance, and use of appropriate antimicrobials wherever indicated. For assessment of hydration clinical signs are generally reliable; however, in severely malnourished children sunken eyes and skin turgor are unreliable. Oral Rehydration Therapy is the cornerstone of management of dehydration. Intravenous fluids are not routinely recommended except in cases of persistent vomiting and/or shock. Majority of cases can be managed in ER and at home. Hospitalization is indicated in infants <3 mo, children with severe dehydration, severe malnutrition, toxic look, persistent vomiting and suspected surgical abdomen. Supplementations with zinc and probiotics have been shown to reduce severity and duration of diarrhea; however evidence does not support the use of antisecretary, antimotility and binding agents. Education of parents about hand hygiene, safe weaning and safe drinking water etc., can help in reducing incidence of this important health problem in the country. PMID:23192407

  3. Acute pain.

    PubMed

    Good, M

    1999-01-01

    The review of acute pain describes the problem of unresolved pain and its effects on the neural, autonomic, and immune systems. Conceptualizations and mechanisms of pain are reviewed as well as theories of pain management. Descriptive studies of patient and nurse factors that inhibit effective pain management are discussed, followed by studies of pharmacological and nonpharmacological interventions. Critical analysis reveals that most studies were atheoretical, and therefore, this proliferation of information lacked conceptual coherence and organization. Furthermore, the nature and extent of barriers to pain management were described, but few intervention studies have been devised, as yet, to modify the knowledge, beliefs, and attitudes of nurses and patients that are barriers to pain management. Although some of the complementary therapies have sufficient research support to be used in clinical pain management, the physiological mechanisms and outcomes need to be studied. It is critical at this time to design studies of interventions to improve assessment, decision making, attentive care, and patient teaching. PMID:10418655

  4. Protein energy malnutrition in India: the plight of our under five children.

    PubMed

    Bhutia, Dechenla Tshering

    2014-01-01

    Protein energy malnutrition (PEM) is a major public health problem in India. This affects the child at the most crucial period of time of development, which can lead to permanent impairment in later life. PEM is measured in terms of underweight (low weight for age), stunting (low height for age) and wasting (low weight for height). The prevalence of stunting among under five is 48% and wasting is 19.8% and with an underweight prevalence of 42.5%, it is the highest in the world. Undernutrition predisposes the child to infection and complements its effect in contributing to child mortality. Lalonde model (1974) is used to look into the various determinants of PEM in under five children and its interrelation in causation of PEM. The determinants of PEM are broadly classified under four distinct categories: Environmental factors including the physical and social environment, behavioral factors, health-care service related and biological factors. The socio-cultural factors play an important role wherein, it affects the attitude of the care giver in feeding and care practices. Faulty feeding practice in addition to poor nutritional status of the mother further worsens the situation. The vicious cycle of poor nutritional status of the mother leading to low birth weight child further exposes the child to susceptibility to infections which aggravates the situation. However, it is seen that percapita income of the family did not have much bearing on the poor nutritional status of the child rather lack of proper health-care services adversely contributed to poor nutritional status of the child. PEM is a critical problem with many determinants playing a role in causing this vicious cycle of undernutrition. With almost half of under five children undernourished in India, the Millennium Development Goal (MDG) of halving the prevalence of underweight by 2015 seems a distant dream. PMID:24791240

  5. Malnutrition-inflammation modifies the relationship of cholesterol with cardiovascular disease.

    PubMed

    Contreras, Gabriel; Hu, Bo; Astor, Brad C; Greene, Tom; Erlinger, Thomas; Kusek, John W; Lipkowitz, Michael; Lewis, Julia A; Randall, Otelio S; Hebert, Lee; Wright, Jackson T; Kendrick, Cynthia A; Gassman, Jennifer; Bakris, George; Kopple, Joel D; Appel, Lawrence J

    2010-12-01

    In moderate and severe CKD, the association of cholesterol with subsequent cardiovascular disease (CVD) is weak. We examined whether malnutrition or inflammation (M-I) modifies the risk relationship between cholesterol levels and CVD events in African Americans with hypertensive CKD and a GFR between 20 and 65 ml/min per 1.73 m². We stratified 990 participants by the presence or absence of M-I, defined as body mass index <23 kg/m² or C-reactive protein >10 mg/L at baseline. The primary composite outcome included cardiovascular death or first hospitalization for coronary artery disease, stroke, or congestive heart failure occurring during a median follow-up of 77 months. Baseline total cholesterol (212 ± 48 versus 212 ± 44 mg/dl) and overall incidence of the primary CVD outcome (19 versus 21%) were similar in participants with (n = 304) and without (n = 686) M-I. In adjusted analyses, the CVD composite outcome exhibited a significantly stronger relationship with total cholesterol for participants without M-I than for participants with M-I at baseline (P < 0.02). In the non-M-I group, the cholesterol-adjusted hazard ratio (HR) for CVD increased progressively across cholesterol levels: HR = 1.19 [95% CI; 0.77, 1.84] and 2.18 [1.43, 3.33] in participants with cholesterol 200 to 239 and ≥240 mg/dl, respectively (reference: cholesterol <200). In the M-I group, the corresponding HRs did not vary significantly by cholesterol level. In conclusion, the presence of M-I modifies the risk relationship between cholesterol level and CVD in African Americans with hypertensive CKD. PMID:20864686

  6. Infection and immunoglobulin levels in Sudanese children with severe protein-energy malnutrition*

    PubMed Central

    Suliman, Omer S. M.; Salih, Mustafa A. M.; Karrar, Zein A.; Mohammed, Abdelrahim O.; Helsing, Chrestover

    2011-01-01

    A hospital-based case control study was carried out to determine the pattern of infections and immunoblobulin levels in Sudanese children with severe protein energy malnutrition (PEM). The pre-dietary rehabilitation levels of the three major immunoglobulins (IgG, IgA and IgM) were compared with those of normal controls, and with the levels after dietary rehabilitation. Eighty one children were included in the study: 49 with severe PEM (23 with marasmus, 17 with marasmic – kwashiorkor and 9 with kwashiorkor), 13 with tuberculosis and 19 healthy children as controls. The study showed high incidence of infections, especially pneumonia and gastrointestinal infections in the malnourished children. Of special concern was the high incidence of urinary tract infection: 13 (26.5%) had significant pyuria and 9 of them had positive urine cultures, mainly Escherichia coli. Eight of the malnourished children also had pulmonary TB, and the ESR and Mantoux tests were not helpful in the diagnosis. The Mantoux test was negative in 88.8% of the malnourished group compared to 62.5% in those malnourished with TB. The malnourished groups had significantly higher plasma levels of the 3 immunoglobulins. While the maramic group attained significantly higher levels of IgG and IgA compared to the marasmic –kwashiorkor and kwashiorkor groups, the 3 groups of PEM showed a uniformly higher level of the IgM. After 2 weeks of rehabilitation, the levels of the 3 immunoglobulins showed no significant changes, except for the IgA which significantly decreased in all malnourished and the oedematous groups, and the IgM which increased significantly in the oedematous group.

  7. Malnutrition alters the cardiovascular responses induced by central injection of tityustoxin in Fischer rats.

    PubMed

    Silva, Fernanda Cacilda Santos; Guidine, Patrícia Alves; Ribeiro, Mara Fernandes; Fernandes, Luciano Gonçalves; Xavier, Carlos Henrique; de Menezes, Rodrigo Cunha; Silva, Marcelo Eustáquio; Moraes-Santos, Tasso; Moraes, Márcio Flávio; Chianca, Deoclécio Alves

    2013-12-15

    Scorpion envenoming and malnutrition are considered two important public health problems in Brazil, involving mainly children. Both these conditions are more common among the economically stratified lower income portion of the population, thus suggesting that these factors should be analyzed concomitantly. It is known that cardiorespiratory manifestations, as cardiac arrhythmias, arterial hypertension and hypotension, pulmonary edema and circulatory failure are the main "causa mortis" of scorpion envenomation. Additionally, there are evidences in the literature that deficiencies in dietary intake endanger the CNS and modify the cardiovascular homeostasis. Then, the objective of this work is to evaluate the protein malnourished effect on cardiovascular responses induced by tityustoxin (TsTX, an α-type toxin extracted from the Tityus serrulatus scorpion venom). Fischer rats (n = 20) were injected i.c.v. with TsTX and divided in control and malnorished groups, which were, respectively, submitted to a control and a low-protein diet. Arterial pressure recordings were done until death of the animals. Although both groups presented an increased mean arterial pressure after TsTX injection, this increase was smaller and delayed in malnourished rats, when compared to control rats. In addition, heart rate increased only in rats from the control group. Finally, malnourished rats had an increase in survival time (9:9/13.5 vs. 15.5:10.5/18 min; p = 0.0009). In summary, our results suggest that the protein restriction attenuates the cardiovascular manifestations resulting from TsTX action on CNS. PMID:24060375

  8. Neonatal malnutrition programs the oxidant function of macrophages in response to Candida albicans.

    PubMed

    Costa, Thacianna Barreto Da; Morais, Natália Gomes De; Pedrosa, Amanda Lúcia F; De Albuquerque, Suênia Da Cunha G; De Castro, Maria Carolina A B; Pereira, Valéria Rêgo A; Cavalcanti, Milena De Paiva; De Castro, Célia Maria M B

    2016-06-01

    Experimental maternal nutrition restriction models are used to investigate short or long-term consequences of nutritional deficiency on puppies' growth. By assuming that the immune function is directly related to host's nutritional status, the current study aims to investigate the effects of neonatal malnutrition on oxidative stress and on the cell death of the alveolar macrophage after in vitro infection by Candida albicans. Wistar rats were suckled by mothers fed on diets containing 17% protein (Nourished group) or 8% protein (Malnourished group) in the current assay. Both groups received the standard diet used in the vivarium until adulthood, after weaning. The results showed that the offspring from mothers fed on low-protein diet presented lower body weight from 5 days of life on. Their low weight remained until adulthood when it was compared to that of rats in the nourished group. Superoxide and nitric oxide production was lower in malnourished animals and it was accompanied by low inducible nitric oxide synthase gene expression levels in systems in which the alveolar macrophages were challenged by immunogenic stimulus. No significant differences were observed in comparisons performed between the nourished and malnourished groups in any of the analyzed cell viability (apoptosis/necrosis) parameters. The fungal inoculum-stimulated system induced higher oxidative stress and cell death by necrosis. The current study demonstrated that dietary restriction during lactation alters the oxidant function of alveolar macrophages in puppies; It happens from the gene transcription step to the release of mediators, thus compromising the host's defenses against Candida albicans. It raises the possibility that Candida albicans may cease to be a commensal fungus to become a pathogen in offspring that have suffered nutritional deficiency during critical developmental periods, due to impaired immune responses. PMID:27001703

  9. Managing child malnutrition in a drought affected district of Rajasthan--a case study.

    PubMed

    Kumar, S; Bhawani, L

    2005-01-01

    Rajasthan is the largest state in the country frequently affected by droughts. The year 2002 happened to be the fifth consecutive year of drought. Almost all districts of the State were hit by it. The district of Baran located in South-East of Rajasthan has 'Sahariya' tribal population concentrated in its Kishanganj and Shahabad blocks. Press reports of starvation deaths amongst tribal children in these blocks created a stir in the local district and the State Government set ups. The paper describes an objective and professional approach to deal with the situation. Rapid nutritional assessment indicated very high prevalence of severe under weight (28.3%) and wasting (4.7%) amongst under five children. Nutrition Care Centres (NCC) were set up in selected villages to provide targeted feeding and care to these children as per WHO guidelines. Local 'Sahariya' community was involved to run these NCC. Intensive public education campaign was carried out to promote improved child caring practices and referral of malnourished children with complication to hospitals. Orientation of press and electronic media on factual details regarding the situation helped create an enabling environment to implement remedial measures. The impact of 'Nutrition Care Centres' assessed after six months was found to be positive in terms of reduction in prevalence of under nutrition in children from 66.7% to 59.6%. Successful management of severe malnutrition amongst children by workers at Nutrition Care Centes and in family settings using standard protocols led to the wide scale replication of the approach by Anganwadi centres in different district of Rajasthan. The State Government also created an additional cadre of worker called 'Sahayogini' to support Anganwadi worker and promote better child caring practices at family level. PMID:16479898

  10. Factors associated with early growth in Egyptian infants: implications for addressing the dual burden of malnutrition.

    PubMed

    Kavle, Justine A; Flax, Valerie L; Abdelmegeid, Ali; Salah, Farouk; Hafez, Seham; Ramzy, Magda; Hamed, Doaa; Saleh, Gulsen; Galloway, Rae

    2016-01-01

    Optimal nutrition is critical to the attainment of healthy growth, human capital and sustainable development. In Egypt, infants and young children face overlapping forms of malnutrition, including micronutrient deficiencies, stunting and overweight. Yet, in this setting, little is known about the factors associated with growth during the first year of life. A rise in stunting in Lower Egypt from 2005 to 2008 prompted this implementation research study, which followed a longitudinal cohort of infants from birth to 1 year of age within the context of a USAID-funded maternal and child health integrated programme. We sought to determine if growth patterns and factors related to early growth differed in Lower and Upper Egypt, and examined the relationship between weight loss and subsequent stunting at 12 months of age. Growth patterns revealed that length-for-age z-score (LAZ) decreased and weight-for-length z-score (WLZ) increased from 6 to 12 months of age in both regions. One-quarter of infants were stunted and nearly one-third were overweight by 12 months of age in lower Egypt. Minimum dietary diversity was significantly associated with WLZ in Lower Egypt (β = 0.22, P < 0.05), but not in Upper Egypt. Diarrhoea, fever and programme exposure were not associated with any growth outcome. Weight loss during any period was associated with a twofold likelihood of stunting at 12 months in Lower Egypt, but not Upper Egypt. In countries, like Egypt, facing the nutrition transition, infant and young child nutrition programmes need to address both stunting and overweight through improving dietary quality and reducing reliance on energy-dense foods. PMID:26373408

  11. Is low-protein diet a possible risk factor of malnutrition in chronic kidney disease patients?

    PubMed

    Noce, A; Vidiri, M F; Marrone, G; Moriconi, E; Bocedi, A; Capria, A; Rovella, V; Ricci, G; De Lorenzo, A; Di Daniele, N

    2016-01-01

    Chronic kidney disease (CKD) is becoming increasingly widespread in the world. Slowing its progression means to prevent uremic complications and improve quality of life of patients. Currently, a low-protein diet (LPD) is one of the tools most used in renal conservative therapy but a possible risk connected to LPD is protein-energy wasting. The aim of this study is evaluate the possible correlation between LPD and malnutrition onset. We enrolled 41 CKD patients, stages IIIb/IV according to K-DIGO guidelines, who followed for 6 weeks a diet with controlled protein intake (recommended dietary allowance 0.7 g per kilogram Ideal Body Weight per day of protein). Our patients showed a significant decrease of serum albumin values after 6 weeks of LDP (T2) compared with baseline values (T0) (P=0.039), whereas C-reactive protein increased significantly (T0 versus T2; P=0.131). From body composition analysis, a significant impairment of fat-free mass percentage at the end of the study was demonstrated (T0 versus T2; P=0.0489), probably related to total body water increase. The muscular mass, body cell mass and body cell mass index are significantly decreased after 6 weeks of LDP (T2). The phase angle is significantly reduced at the end of the study compared with basal values (T0 versus T2; P=0.0001, and T1 versus T2; P=0.0015). This study indicated that LPD slows down the progression of kidney disease but worsens patients' nutritional state. PMID:27551517

  12. What Political Framework Is Necessary to Reduce Malnutrition? A Civil Society Perspective.

    PubMed

    Walter, Bernhard

    2016-01-01

    Around 800 million people worldwide are still starving. Around 2 billion are somehow able to allay their hunger yet remain malnourished because their food does not contain sufficient nutrients. There are many reasons for this: for people living in poverty and precarious conditions, the priority is to fill their stomach, and the quality of food seems less important. Since the 1960s, global food production has been focused on increasing yield, not food quality. Mass-produced convenience food with high fat and carbohydrate contents but containing few nutrients is on the rise and - as a result of price wars - often replaces healthier locally grown products. To overcome global hunger and malnutrition, civil society organizations urge governments to turn towards sustainable and human rights-based development, including sustainable agricultural and fishing policies, to contribute to the eradication of poverty. This development is first and foremost guided by the right to food. In a policy that enables farmers to produce enough food that is healthy and rich in nutrients, the following principles should be fulfilled. Governments should assume responsibility for the international impacts of their agricultural policy decisions. The food sovereignty of other countries should be respected. Policies should enable self-supply of the population with healthy food and should promote the protection of resources, the climate, biodiversity and animal welfare. Strengthening rural structures, local economies, labor rights and small-scale food producers, establishing public programs that provide locally produced food, applying stringent standards for food labeling and the regulation of unhealthy products and paying special attention to the first 1,000 days of life as the starting point of a good and healthy well-being are core elements of such a political framework. PMID:27198237

  13. Innate immunity gene expression changes in critically ill patients with sepsis and disease-related malnutrition

    PubMed Central

    Sarnecka, Agnieszka; Dąbrowska, Aleksandra; Kosałka, Katarzyna; Wachowska, Ewelina; Bałan, Barbara J.; Jankowska, Marta; Korta, Teresa; Niewiński, Grzegorz; Kański, Andrzej; Mikaszewska-Sokolewicz, Małgorzata; Omidi, Mohammad; Majewska, Krystyna; Słotwińska, Sylwia M.

    2015-01-01

    The aim of this study was an attempt to determine whether the expression of genes involved in innate antibacterial response (TL R2, NOD 1, TRAF6, HMGB 1 and Hsp70) in peripheral blood leukocytes in critically ill patients, may undergo significant changes depending on the severity of the infection and the degree of malnutrition. The study was performed in a group of 128 patients with infections treated in the intensive care and surgical ward. In 103/80.5% of patients, infections had a severe course (sepsis, severe sepsis, septic shock, mechanical ventilation of the lungs). Clinical monitoring included diagnosis of severe infection (according to the criteria of the ACC P/SCC M), assessment of severity of the patient condition and risk of death (APACHE II and SAPS II), nutritional assessment (NRS 2002 and SGA scales) and the observation of the early results of treatment. Gene expression at the mRNA level was analyzed by real-time PCR. The results of the present study indicate that in critically ill patients treated in the IC U there are significant disturbances in the expression of genes associated with innate antimicrobial immunity, which may have a significant impact on the clinical outcome. The expression of these genes varies depending on the severity of the patient condition, severity of infection and nutritional status. Expression disorders of genes belonging to innate antimicrobial immunity should be diagnosed as early as possible, monitored during the treatment and taken into account during early therapeutic treatment (including early nutrition to support the functions of immune cells). PMID:26648775

  14. Household food access and child malnutrition: results from the eight-country MAL-ED study

    PubMed Central

    2012-01-01

    malnutrition. PMID:23237098

  15. Hepatoprotective and nephroprotective effects of Cnidoscolus aconitifolius in protein energy malnutrition induced liver and kidney damage

    PubMed Central

    Oyagbemi, Ademola A.; Odetola, Adebimpe A.

    2013-01-01

    Introduction: This study was designed to evaluate the ameliorative and hypocholesterolemic effects of dietary supplementation of Cnidoscolus aconitifolius leaf meal (CALM) on hepatic injury and kidney injury associated with protein energy malnutrition (PEM). Materials and Methods: In this study, PEM was induced in weaning male Wistar albino rats by feeding them with low protein diet for 2 weeks. The effects of several recovery diets containing 20% soya protein or 20% C. aconitifolius in place of soya protein or 10% soya proteins with 10% C. aconitifolius or commercial rat feed were assessed in PEM rats. Plasma biochemical parameters were assessed as well. Results: After the induction of PEM, results obtained showed significant increase in alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total proteins (T.P), total bilirubin (T.Bil), triglycerides, total cholesterol, low density lipoproteins (LDL), blood urea nitrogen (BUN), and creatinine with significant reduction in plasma high density lipoproteins (HDL), albumin, sodium (Na+), potassium (K+), chloride (Cl−), bicarbonate (HC03−), and phosphate (P042−) in PEM rats. Upon introduction of recovery diets containing 20% soya protein or 20% C. aconitifolius in place of soya protein or 10% soya proteins with 10% C. aconitifolius or commercial rat feed for 4 weeks caused significant (P < 0.05) reduction in plasma values of ALP, ALT, AST, T.bil, T.P., LDL, total cholesterol, triglycerides, BUN, creatinine, and significant increase in HDL and complete restoration of plasma electrolytes. Conclusions: C. aconitifolius in protein deficient diets has a protective role against hepatic injury and renal damage associated with PEM. PMID:24174819

  16. Protein energy malnutrition (PEM), brain and various facets of child development.

    PubMed

    Udani, P M

    1992-01-01

    Protein energy malnutrition (PEM) is a global problem. Nearly 150 million children under 5 years in the world and 70-80 million in India suffer from PEM, nearly 20 million in the world and 4 million in India suffer from severe forms of PEM, viz., marasmus, kwashiorkor and marasmic kwashiorkor. The studies in experimental animals in the west and children in developing countries have revealed the adverse effects of PEM on the biochemistry of developing brain which leads to tissue damage and tissue contents, growth arrest, developmental differentiation, myelination, reduction of synapses, synaptic transmitters and overall development of dendritic activity. Many of these adverse effects have been described in children in clinical data, biochemical studies, reduction in brain size, histology of the spinal cord, quantitative studies and electron microscopy of sural nerve, neuro -CT scan, magnetic resonance imaging (MRI) and morphological changes in the cerebellar cells. Longer the PEM, younger the child, poorer the maternal health and literacy, more adverse are the effects of PEM on the nervous system. Just like the importance of nutrients on the developing brain, so are the adverse effects on the child development of lack of environmental stimulation, emotional support and love and affection to the child. When both the adverse factors are combined, the impact is severe. Hence prevention of PEM in pregnant and lactating mothers, breast feeding, adequate home based supplements, family support and love will improve the physical growth, mental development, social competence and academic performance of the child. Hence nutritional rehabilitation, psychosocial and psychomotor development of the child should begin in infancy and continue throughout. It should be at all levels, most important being in family, school, community and various intervention programmes, local, regional and national. Moreover medical students, health personnel, all medical disciplines concerned with

  17. Health at the borders: Bayesian multilevel analysis of women's malnutrition determinants in Ethiopia

    PubMed Central

    Delbiso, Tefera Darge; Rodriguez-Llanes, Jose Manuel; Altare, Chiara; Masquelier, Bruno; Guha-Sapir, Debarati

    2016-01-01

    Background Women's malnutrition, particularly undernutrition, remains an important public health challenge in Ethiopia. Although various studies examined the levels and determinants of women's nutritional status, the influence of living close to an international border on women's nutrition has not been investigated. Yet, Ethiopian borders are regularly affected by conflict and refugee flows, which might ultimately impact health. Objective To investigate the impact of living close to borders in the nutritional status of women in Ethiopia, while considering other important covariates. Design Our analysis was based on the body mass index (BMI) of 6,334 adult women aged 20–49 years, obtained from the 2011 Ethiopian Demographic and Health Survey (EDHS). A Bayesian multilevel multinomial logistic regression analysis was used to capture the clustered structure of the data and the possible correlation that may exist within and between clusters. Results After controlling for potential confounders, women living close to borders (i.e. ≤100 km) in Ethiopia were 59% more likely to be underweight (posterior odds ratio [OR]=1.59; 95% credible interval [CrI]: 1.32–1.90) than their counterparts living far from the borders. This result was robust to different choices of border delineation (i.e. ≤50, ≤75, ≤125, and ≤150 km). Women from poor families, those who have no access to improved toilets, reside in lowland areas, and are Muslim, were independently associated with underweight. In contrast, more wealth, higher education, older age, access to improved toilets, being married, and living in urban or lowlands were independently associated with overweight. Conclusions The problem of undernutrition among women in Ethiopia is most worrisome in the border areas. Targeted interventions to improve nutritional status in these areas, such as improved access to sanitation, economic and livelihood support, are recommended. PMID:27388539

  18. Carbaodeim: A natural haematinic blend for treatment of dimorphic anemia of malnutrition

    PubMed Central

    Swar, Mohamed Osman; Osman, Atika Mohamed

    2014-01-01

    Sudanese nomadic tribes living in the Sahara Region west of Khartoum State depend completely on food made of sour milk and other milk products cooked with onion and dried meat. This is usually added to a porridge made of sorghum flour. Goat and sheep milk is the main component and green vegetables are not commonly taken with this meal. Adults, who move out of their residential areas may have access to other types of food in towns and cities while mothers and children, staying always at home, do not have similar chances. Furthermore, in these dessert areas there is always difficulty in reaching health care facilities and getting medicines. Children from these areas who presented to Ombada Teaching Hospital – west of Omdurman- had very low hemoglobin and their peripheral blood picture showed dimorphic type of anemia. In the search for locally available ingredients that can prevent the occurrence of this type of anemia among the affected population, we studied the constituents of the commonly available fruits and vegetables in the area. We succeeded to formulate a blend (Carbaodeim) made of Carrots (25 gm), Baobab (100 gm) and Godeim (100 gm) which is found to contain iron (34.8 mg), folic acid (2.5 mg), ascorbic acid (372.8 mg), vitamin A (7000 mg), calcium (896.7 mg) and potassium (1910 mg), with many other components that have high nutritional value. This blend is easy to make, safe, nutritious, refreshing and cost effective. Carbaodeim is a naturally available and cost effective haematinic blend that might be added to the food menu of nomadic people as well as patients admitted to hospital with malnutrition or dimorphic type of anemia. PMID:27493404

  19. Relationship between intra-household food distribution and coexistence of dual forms of malnutrition

    PubMed Central

    Sutrisna, Bambang; Hardinsyah, Hardinsyah; Djuwita, Ratna; Korib M, Mondastri; Syafiq, Ahmad; Tilden, Atmarita; Najib, Mardiati

    2015-01-01

    BACKGROUND/OBJECTIVES The relationship between food intake and nutritional status has been clearly established. Yet, there are only limited studies on food intake among family members and their nutritional status. The study examined the relationship between intra-household food distribution and coexistence of dual forms of malnutrition (DFM) in the same household. SUBJECTS/METHODS Households with a malnourished child and overweight mother were categorized as DFM. Intra-household food distribution among family members was reported using ratios, which are a measure of individual intakes as compared to all household member intakes adjusted to RDA. RESULTS A 1,899 families were included in the study. The prevalence of DFM was 29.8% (95%CI 26.5-31.2). Children consumed lower amounts of energy (OR 1.34; 95%CI 1.06-1.69, P = 0.011), carbohydrates (OR 1.2; 95%CI1.03-1.61, P = 0.022), protein (OR 1.3; 95%CI 1.03-1.64, P = 0.026), and fat (OR 1.3; 95%CI 1.05-1.66, P = 0.016) than their mothers and other family members. In contrast, mothers consumed more carbohydrates than children and other family members (OR1.24; 95%CI 1.02-1.51, P = 0.03). CONCLUSIONS This study is the first to report on the food distribution among family members and its relationship with occurrence of DFM in Indonesia. The results confirm the occurrence of an unequal food distribution between children and mothers, which increases risk of DFM in the household. The results also demonstrate that nutritional education at the household level is important to increase awareness of the impact of DFM. PMID:25861424

  20. Identification of Comprehensive Geriatric Assessment Based Risk Factors for Malnutrition in Elderly Asian Cancer Patients

    PubMed Central

    Ong, Whee Sze; Rajasekaran, Tanujaa; Nee Koo, Khai; Chan, Li Li; Poon, Donald; Roy Chowdhury, Anupama; Krishna, Lalit; Kanesvaran, Ravindran

    2016-01-01

    Purpose Elderly cancer patients are at increased risk for malnutrition. We aim to identify comprehensive geriatric assessment (CGA) based clinical factors associated with increased nutritional risk and develop a clinical scoring system to identify nutritional risk in elderly cancer patients. Patients and Methods CGA data was collected from 249 Asian patients aged 70 years or older. Nutritional risk was assessed based on the Nutrition Screening Initiative (NSI) checklist. Univariate and multivariate logistic regression analyses were applied to assess the association between patient clinical factors together with domains within the CGA and moderate to high nutritional risk. Goodness of fit was assessed using Hosmer-Lemeshow test. Discrimination ability was assessed based on the area under the receiver operating characteristics curve (AUC). Internal validation was performed using simulated datasets via bootstrapping. Results Among the 249 patients, 184 (74%) had moderate to high nutritional risk. Multivariate logistic regression analysis identified stage 3–4 disease (Odds Ratio [OR] 2.54; 95% CI, 1.14–5.69), ECOG performance status of 2–4 (OR 3.04; 95% CI, 1.57–5.88), presence of depression (OR 5.99; 95% CI, 1.99–18.02) and haemoglobin levels <12 g/dL (OR 3.00; 95% CI 1.54–5.84) as significant independent factors associated with moderate to high nutritional risk. The model achieved good calibration (Hosmer-Lemeshow test’s p = 0.17) and discrimination (AUC = 0.80). It retained good calibration and discrimination (bias-corrected AUC = 0.79) under internal validation. Conclusion Having advanced stage of cancer, poor performance status, depression and anaemia were found to be predictors of moderate to high nutritional risk. Early identification of patients with these risk factors will allow for nutritional interventions that may improve treatment tolerance, quality of life and survival outcomes. PMID:27231951