Effects of massive bowel resection

2020 ◽  
pp. 2911-2916
Author(s):  
Stephen J. Middleton ◽  
Simon M. Gabe ◽  
Raymond J. Playford
Keyword(s):  
Small Bowel ◽  
Protein Energy Malnutrition ◽  
Intestinal Resection ◽  
Intestinal Transplantation ◽  
Renal Stones ◽  
Electrolyte Solutions ◽  
Venous Access ◽  
Vitamin B ◽  
Protein Energy

Major vascular events involving the superior mesenteric artery and small-bowel volvulus are the commonest reasons for adults to require massive intestinal resection. The ability of the residual bowel to adapt after resection varies greatly between patients, but common postoperative problems include sepsis, diarrhoea (or high-output stoma losses), fluid and electrolyte imbalance, malnourishment (protein–energy malnutrition, mineral and vitamin deficiencies), gallstones, renal stones, and psychological illness. Where appropriate, oral nutrition, initially consisting of low-volume polymeric feeds administered by nasogastric or enteral tube, should be started within the first few days of surgery. Small-volume, frequent, solid or semisolid meals with low long-chain triglycerides and (when colon is in continuity) oxalate content should be introduced subsequently, and isotonic electrolyte solutions given as required. Oral multivitamin and mineral supplements are usually needed, and vitamin B12 injections may be required. There should be regular long-term monitoring of fat-soluble vitamins (A and D), vitamin B12, folate, magnesium, zinc, and bone status. Long-term intravenous nutrition is sometimes needed. Growth factor administration, especially glucagon-like peptide-2 analogues, may stimulate bowel adaptation. Small-bowel lengthening may be considered for patients with dilated bowel close to the length required. Those who are dependent on peripheral nutrition and develop complications such as loss of venous access or liver disease should be considered for intestinal transplantation.

scholarly journals Nutritional deficiencies and later behavioural development

2000 ◽  
Vol 59 (1) ◽  
pp. 47-54 ◽  
Author(s):  
S. M. Grantham-McGregor ◽  
S. P. Walker ◽  
S. Chang
Keyword(s):  
Cultural Context ◽  
School Achievement ◽  
Protein Energy Malnutrition ◽  
Term Effect ◽  
Nutritional Deficiencies ◽  
Long Term Effects ◽  
Protein Energy ◽  
Long Term Effect ◽  
Long Term Follow Up

The literature on the long-term effects of nutritional deficiencies in early life is reviewed. The severity and duration of the deficiency, the stage of the children’s development, the biological condition of the children and the socio-cultural context may all modify the effect. There is substantial evidence that reduced breast-feeding, small-for-gestational-age birth weight, Fe and I deficiency, and protein-energy malnutrition (PEM) are associated with long-term deficits in cognition and school achievement. However, all these conditions are associated with poverty and poor health, which may account for the association. It is difficult to establish that the long-term relationship is causal, as it requires a randomized treatment trial with long-term follow-up. Such studies are only available for I deficiency in utero and early childhood PEM. Results from these studies indicate that I deficiency has a long-term effect and PEM probably has a long-term effect.

Concurrent validity of an appetite questionnaire in peritoneal dialysis

2020 ◽  
Vol 40 (1) ◽  
pp. 41-46
Author(s):  
Thalita L Melo ◽  
Marion S Meireles ◽  
Maria A Kamimura ◽  
Lilian Cuppari
Keyword(s):  
Peritoneal Dialysis ◽  
Handgrip Strength ◽  
Protein Energy Malnutrition ◽  
Cell Mass ◽  
Bioelectrical Impedance ◽  
Poor Appetite ◽  
The Third ◽  
Protein Energy ◽  
Hedonic Scale

Background: Decreased appetite is a symptom often found in chronic kidney disease. Poor appetite may negatively affect food intake, what in long-term may contribute to the development of protein–energy malnutrition. Methods: An Appetite and Food Satisfaction Questionnaire (AFSQ) was developed consisting of a question that assesses the level of appetite through a facial hedonic scale and five other questions adapted from the Buckner and Dwyer tool that assess some aspects related to food satisfaction. Each question received an arbitrary score of 0 to 3. The sum of the scores ranged from 0, the best, to 18, the worst condition. Nutritional status was assessed through seven-point SGA, bioelectrical impedance, anthropometry, and handgrip strength (HGS). Results: Eighty-four patients on peritoneal dialysis (PD; 58.3% women, mean age 54.7 ± 14.2 years, and body mass index (BMI) of 26.0 ± 4.8 kg/m2) were evaluated. Median AFSQ score was 4.0 (1.0–6.8; median and IQ). Patients were divided into tertiles according to the AFSQ score. Comparing the third tertile (score ≥ 6) with the first tertile (score < 2), the prevalence of malnutrition was greater (32.1% vs. 6.7%, respectively, p = 0.005), HGS adequacy was lower (74.6% vs. 87.3%, p = 0.001), and body cell mass index (5.7% vs. 7.4%, p = 0.001) and lean BMI were lower (11% vs. 13.4%, p = 0.001) in the third tertile. Conclusion: Poor appetite and food satisfaction determined by the questionnaire was related to worse nutritional markers, indicating AFSQ as a valid easy-to-use tool to be applied as an initial screening to identify PD patients with potential risk of malnutrition.

Protein-energy malnutrition at mid-adulthood does not imprint long-term metabolic consequences in male rats

2015 ◽  
Vol 55 (4) ◽  
pp. 1423-1433 ◽  
Author(s):  
Ananda Malta ◽  
Egberto Gaspar de Moura ◽  
Tatiane Aparecida Ribeiro ◽  
Laize Peron Tófolo ◽  
Latifa Abdennebi-Najar ◽  
...  
Keyword(s):  
Protein Energy Malnutrition ◽  
Male Rats ◽  
Protein Energy

scholarly journals TERAPI NUTRISI PADA NEFROPATI DIABETIK, GAGAL JANTUNG KRONIK NYHA III, KARSINOMA SERVIKS, POST OPERASI URS BILATERAL, REPLACE DJ STENT

2021 ◽  
Vol 4 (1) ◽  
pp. 1-11
Author(s):  
Andi Syurma Sari Ismail ◽  
Agussalim Bukhari
Keyword(s):  
Diabetes Mellitus ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Protein Energy Malnutrition ◽  
Vitamin B ◽  
Diabetic Kidney ◽  
Protein Energy ◽  
Dj Stent

Nefropati Diabetik or Diabetic Kidney Disease (DKD) adalah perubahan struktural dan fungsional patologis spesifik yang terlihat pada ginjal pasien Diabetes Mellitus (DM). Nefropati diabetik menyebabkan berbagai perubahan pada kapiler dan arteri, penebalan membran endotel, trombosis dan inflamasi. Kondisi ini terlihat setelah satu atau dua tahun menderita DM. Diabetes mellitus juga dapat berkontribusi pada gagal jantung kronik dengan mekanisme sistemik, miokard, dan seluler. Semua faktor inilah yang dapat menyebakan malnutrisi. Ini adalah laporan kasus dari seorang wanita berusia 50 tahun, dengan keluhan tidak ada asupan oral yang didiagnosis dengan moderate protein energy malnutrition, nefropati diabetik, gagal jantung kronik NYHA III dengan karsinoma serviks dan pasca operasi URS Bilateral, Replace DJ Stent. Terapi nutrisi diberikan 720 kkal, ditingkatkan bertahap menjadi 2000 kkal sesuai kemampuan dan kondisi pasien, dengan komposisi 0,8-1 g / kg BB ideal / hari protein dan ekstrak ikan gabus, 45-50% karbohidrat dan 41-47% lemak diikuti dengan suplementasi seng (20 mg / hari), vitamin B kompleks, dan kurkumin. Terjadi peningkatan asupan energi dari 245 kkal menjadi 2.142,6 kkal diikuti dengan peningkatan hasil laboratorium seperti penurunan ureum / kreatinin (114 / 3,2 menjadi 84 / 2,05 mg / dl, penurunan leukosit (14.000 menjadi 7200 / µl), penurunan asam urat (13,1 hingga 7,3) mg / dl, penurunan kadar gula darah (199 menjadi 162 g / dl), peningkatan hemoglobin (6,7 hingga 8,2 g / dl), peningkatan kadar natrium (128 hingga 131 mmol / l) Kesimpulan: Terapi gizi yang adekuat selama 16 hari dapat memperbaiki kondisi, status metabolisme dan kualitas hidup pasien.

scholarly journals SEVERE INTESTINAL FAILURE IN A CHAGAS’S DISEASE PATIENT AFTER TOTAL COLECTOMY PLUS PARTIAL ILEECTOMY

2017 ◽  
Vol 5 (1) ◽  
pp. 28
Author(s):  
Thaís Castro Duarte ◽  
Fernanda Godoi Melo ◽  
José Rodrigues Santos-Júnior ◽  
Marcel P. Moussa ◽  
Daurea Abadia De-Souza
Keyword(s):  
Total Colectomy ◽  
Protein Energy Malnutrition ◽  
Elemental Diet ◽  
Intestinal Failure ◽  
Disease Patient ◽  
Intestinal Resection ◽  
Nutritional Therapy ◽  
Sigmoid Volvulus ◽  
Low Fat ◽  
Protein Energy

Introduction: To report the clinical course of a Chagas’s disease patient with severe intestinal failure after resection of the total colon and terminal ileum.Case Report: The patient underwent rectosigmoidectomy (of the sigmoid volvulus, December 2009) and total colectomy plus partial ileectomy (May 2011). Patient evolved with multiple hospitalizations caused by severe diarrhea (up to 23 stools/day), hydroelectrolyte disturbance and acute renal failure, severe protein-energy malnutrition [loss of 34.9% of usual body weight (uBW)], and multiple episodes of sepsis. Were prescribed parenteral nutrition solutions exclusively or concurrently with very small volumes (e.g., 40ml/day) of semi-elemental diet with low fat and high protein. After several weeks predetermined amounts of carbohydrate-rich foods (potatoes, rice, pasta, cassava), vegetables (chayote, carrots), low-fat meat, cream crackers, coconut water and fruit (watermelon, melon, banana) were progressively introduced. After 36 months, the patient was metabolically stable (BW=67.2 kg, weight recovery of 23.6 kg), with hydroelectrolytic balance. Due to the recovery of the functional capacity, the patient was advised to return to his work activities. Conclusions: Chagas’s disease patient submitted to intestinal resection may have severe intestinal failure and protein-energy malnutrition. Specialized nutritional therapy and clinical and laboratory monitoring by a multidisciplinary team, can contribute to better prognostic. 

scholarly journals Evaluation of the efficacy of Shiva modaka on Hematological, Biochemical and Immunological Parameters in the management of malnutrition among school going children

2020 ◽  
Vol 5 (01) ◽  
Author(s):  
Pradeep EK ◽  
Ravishankar Shenoy
Keyword(s):  
Clinical Study ◽  
Adverse Effects ◽  
Protein Energy Malnutrition ◽  
Therapeutic Interventions ◽  
Early Age ◽  
Short Term ◽  
Immunological Parameters ◽  
Protein Energy ◽  
Early Schooling

Malnutrition is an issue of global dimensions affecting all ages. Malnutrition in children is common in early age especially during infancy and weaning. However, it also prevails during early schooling. In adults and elderly it is studied as under Protein Energy Malnutrition. It has not only short term adverse effects but also exhibits long term sustained and progressive effects. Kuposhana/Bala Shosha is explained in the Ayurveda literatures and elaborate therapeutic interventions are also described. The disease Karshya also applies to this condition. Shiva Modaka, a drug described under Bala Roga seems to act on vide dimensions of pediatric health with indications in common pediatric ailments too. The present clinical study is an effort to evaluate the efficacy of the said drug on hematological, biochemical and immunological parameters in Malnutrition in school going children.

Protein-energy malnutrition as a risk factor for increased morbidity in long-term hemodialysis patients

2000 ◽  
Vol 10 (1) ◽  
pp. 7-15 ◽  
Author(s):  
Marietjie Herselman ◽  
M.Rafique Moosa ◽  
Theunis J Kotze ◽  
Martinette Kritzinger ◽  
Susan Wuister ◽  
...  
Keyword(s):  
Risk Factor ◽  
Protein Energy Malnutrition ◽  
Hemodialysis Patients ◽  
Protein Energy

scholarly journals Angular Cheilitis pada Anak yang Mengalami Defisiensi Nutrisi

e-GIGI ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 196
Author(s):  
Verena M. Ekarisma ◽  
Christy N. Mintjelungan ◽  
Aurelia S. R. Supit ◽  
Johanna A. Khoman
Keyword(s):  
Literature Review ◽  
Nutritional Status ◽  
Protein Energy Malnutrition ◽  
Nutritional Deficiencies ◽  
Vitamin B ◽  
Cross Sectional ◽  
Oral Infections ◽  
Protein Energy ◽  
Complex Deficiency

Abstract: Nutritional problems in Indonesia and developing countries in general are still dominated by the protein energy malnutrition (PEM) and other micronutrient problems such as iron deficiency and vitamin B complex deficiency. Nutritional deficiency is always accompanied by malnutrition in childhood. Children face the greatest risk of developing malnutrition. This can lead the children to become susceptible to infectious diseases. One of the most common oral infections in children with nutritional deficiencies is angular cheilitis. This study was aimed to review nutritional deficiencies in children with angular cheilitis. This was a literature review study. This study reviewed topics related to nutritional deficiencies in children from previous studies. There were 12 literature reviewed in this study consisting of 11 cross-sectional studies and one simple experimental study. The results showed that angular cheilitis was more common in children with malnutrition based on BMI for age measurement and moderate nutritional status based on MUAC measurements. Angular cheilitis type 1 were most commonly found in children with mild nutritional status, while types 2, 3 and 4 were most commonly found in children with moderate nutritional status. None of types 2, 3, and 4 were seen in children with good nutritional status. In conclusion, children with angular cheilitis are mostly deficient in vitamin B complex.Keywords: angular cheilitis, children, nutritional deficiencies Abstrak: Masalah nutrisi di Indonesia dan di negara berkembang pada umumnya masih didominasi oleh masalah kurang energi dan protein (KEP) serta masalah nutrisi mikro lainnya seperti defisiensi zat besi dan defisiensi vitamin B kompleks. Defisiensi nutrisi selalu dihubungkan dengan kekurangan gizi pada masa anak-anak. Anak-anak menghadapi risiko paling besar untuk mengalami kurang gizi. Defisiensi nutrisi dapat menyebabkan anak rentan terhadap penyakit infeksi. Salah satu penyakit infeksi rongga mulut yang sering terjadi pada anak dengan defisiensi nutrisi ialah angular cheilitis. Penelitian ini bertujuan untuk mengetahui gambaran defisiensi nutrisi pada anak dengan angular cheilitis. Jenis penelitian ialah suatu literature review. Penelitian ini mempelajari topik terkait defisiensi nutrisi pada anak dengan angular cheilitis dari penelitian-penelitian sebelumnya. Pustaka yang diulas dan dipelajari dalam penelitian ini sebanyak 12 pustaka yang terdiri dari 11 studi potong lintang dan satu eksperimental sederhana. Hasil penelitian menunjukkan bahwa lesi angular cheilitis lebih sering ditemukan pada anak dengan status gizi kurang berdasarkan pengukuran IMT/U dan status kurang nutrisi sedang berdasarkan pengukuran LLA. Lesi angular cheilitis tipe 1 paling banyak ditemukan pada anak dengan status kurang nutrisi ringan, sedangkan tipe 2, 3 dan 4 paling banyak ditemukan pada anak dengan status kurang nutrisi sedang dan tidak satu pun lesi tipe 2, 3, 4 terlihat pada anak dengan status nutrisi baik. Simpulan penelitian ini ialah anak dengan angular cheilitis paling banyak mengalami defisiensi nutrisi mikro vitamin B kompleks.Kata kunci: angular cheilitis, anak, defisiensi nutrisi

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