Identifying Targets for the Prevention of Childhood Undernutrition in a Resource-Limited Peri-Urban Ecuadorian Community

2021 ◽  
pp. 037957212098250
Author(s):  
Suzanna L. Attia ◽  
Wolf-Peter Schmidt ◽  
Janeth Ceballos Osorio ◽  
Thomas Young ◽  
Aric Schadler ◽  
...  

Background: In middle-income countries, malnutrition concentrates in marginalized populations with a lack of effective preventive strategies. Objective: Identify risk factors for undernutrition in a peri-urban Ecuadorian community of children aged 12 to 59 months. Methods: Data from a cross-sectional survey in 2011 of children 1 to 5 years were analyzed including demographic data, medical history and examination, food frequency questionnaire (FFQ), anthropometric measurements, and blood for complete blood count, C-reactive protein, vitamin A, iron, and zinc levels. Dietary Diversity Score (DDS) was calculated from FFQ. Bivariate and multivariate analysis assessed effects on primary outcome of undernutrition by DDS, vitamin deficiencies, and demographic and nutritional data. Results: N = 67, 52.2% undernourished: 49.3% stunted, 25.4% underweight, and 3% wasted; 74.6% (n = 50) were anemic and 95.1% (n = 39) had low serum zinc. Dietary Diversity Score was universally low (mean 4.91 ± 1.36, max 12). Undernutrition was associated with lower vitamin A levels (20 306, IQR: 16605.25-23973.75 vs 23665, IQR: 19292-26474 ng/mL, P = .04); underweight was associated with less parental report of illness (43.8%, n = 7 vs 80% n = 40, P = .005) and higher white blood count (13.7, IQR: 11.95-15.8 vs 10.9, IQR: 7.8-14.23 × 109/L, P = .02). In multiple regression, risk of undernutrition decreased by 4% for every $10 monthly income increase (95 CI%: 0.5%-7.4%, P = .02, n = 23); risk of underweight decreased by 0.06 for every increased DDS point (adjusted odds ratio: 0.06; 95 CI%: 0.004-0.91, P = .04, n = 23). Conclusions: In this peri-urban limited resource, mostly Indigenous Ecuadorian community, stunting exceeds national prevalence, lower monthly income is the strongest predictor of undernutrition, lower DDS can predict some forms of undernutrition, and vitamin deficiencies are associated with but not predictive of undernutrition.

2020 ◽  
Author(s):  
Tsegahun Worku Brhanie ◽  
Walelgn Tefera ◽  
Mamo Dereje

Abstract Background: Adequate and healthy diet during pregnancy is essential for the health of both mother and newborn. Dietary diversity is a proxy indicator of maternal nutrient adequacy. However, little is documented on the prevalence of dietary diversity among pregnant women. This study was aimed to assess the dietary diversity practice and associated factors among pregnant women attending antenatal care in health centers of the coffee keranyo sub city, Addis Ababa, Ethiopia. Methods: Institution based cross-sectional study was conducted on 406 randomly selected pregnant women attending ANC in health centers of the coffee keranyo sub city, Addis Ababa from March 2-April 2/ 2018. Data were collected by using interviewer and 24 H dietary recall method. Data had entered and analyzed using SPSS version 21. Multiple logistic regression was run to assess factors associated with the dependent variable at P<0.05. Results: The mean Dietary Diversity Score of pregnant women was 5. 45+-1. 83. About 60.9% of pregnant women had good dietary diversity practice. Pregnant women who learned collage and above had more dietary diversity practice than the illiterate one [AOR=2.26, 95% CI: (1.066, 4.808)]. Pregnant women with monthly income more than 5,000 ETB had more dietary diversity than income less than 2,000 ETB [AOR=2.33, 95% CI: (1.234, 4.416)]. Pregnant women at second antenatal care visit had more dietary diversity than at the first visit [AOR=2.42, 95% CI: (1.183, 4.952)]. Having nutrition information during pregnancy increases 2 times better dietary diversity practice than none informed ones [AOR=2.10, 95% CI: (1.294, 3.422)].Conclusions: The mean Dietary Diversity Score of pregnant mothers was 5.45. And 60.9% of pregnant women had a good dietary diversity score, whereas 39.1 % of them had a poor diet diversity score. Mothers’ education, monthly income, second and third antenatal care visit and nutrition information had a significantly associated with pregnant mothers’ dietary diversity.


2014 ◽  
Vol 99 (6) ◽  
pp. 723-728 ◽  
Author(s):  
Sahin Kahramanca ◽  
Oskay Kaya ◽  
Gulay Ozgehan ◽  
Hakan Guzel ◽  
Cem Azili ◽  
...  

Abstract Therapeutic delays in cases of external incarcerated hernias typically result in increasing morbidity, mortality, and health expenditures. We investigated the diagnostic role of blood fibrinogen level, white blood count (WBC), mean platelet volume (MPV), and platelet distribution width (PDW) in patients with incarcerated hernia. Two groups, each containing 100 patients, were studied. Group A underwent elective, and group B underwent incarcerated and urgent external hernia repair. We observed high fibrinogen and WBC levels but low MPV and PDW values for patients in group B. Contrary to our expectations, we found lower MPV and PDW values in the complicated group than in the elective group. The morbidity rate and cost burden were higher in group B, and the results were statistically significant. Early operation should be recommended for patients with incarcerated external hernias if their fibrinogen and WBC levels are high.


2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Mattia Bellan ◽  
Danila Azzolina ◽  
Eyal Hayden ◽  
Gianluca Gaidano ◽  
Mario Pirisi ◽  
...  

Introduction. The clinical course of Coronavirus Disease 2019 (COVID-19) is highly heterogenous, ranging from asymptomatic to fatal forms. The identification of clinical and laboratory predictors of poor prognosis may assist clinicians in monitoring strategies and therapeutic decisions. Materials and Methods. In this study, we retrospectively assessed the prognostic value of a simple tool, the complete blood count, on a cohort of 664 patients ( F 260; 39%, median age 70 (56-81) years) hospitalized for COVID-19 in Northern Italy. We collected demographic data along with complete blood cell count; moreover, the outcome of the hospital in-stay was recorded. Results. At data cut-off, 221/664 patients (33.3%) had died and 453/664 (66.7%) had been discharged. Red cell distribution width (RDW) ( χ 2 10.4; p < 0.001 ), neutrophil-to-lymphocyte (NL) ratio ( χ 2 7.6; p = 0.006 ), and platelet count ( χ 2 5.39; p = 0.02 ), along with age ( χ 2 87.6; p < 0.001 ) and gender ( χ 2 17.3; p < 0.001 ), accurately predicted in-hospital mortality. Hemoglobin levels were not associated with mortality. We also identified the best cut-off for mortality prediction: a NL   ratio > 4.68 was characterized by an odds ratio for in-hospital mortality   OR = 3.40 (2.40-4.82), while the OR for a RDW > 13.7 % was 4.09 (2.87-5.83); a platelet   count > 166,000 /μL was, conversely, protective (OR: 0.45 (0.32-0.63)). Conclusion. Our findings arise the opportunity of stratifying COVID-19 severity according to simple lab parameters, which may drive clinical decisions about monitoring and treatment.


2016 ◽  
Vol 22 (1) ◽  
Author(s):  
Kerem Doğa Seçkin ◽  
Mehmet Fatih Karslı ◽  
Burak Yücel ◽  
Elif Akkaş Yılmaz ◽  
Murat Öz ◽  
...  

<p>OBJECTIVE: The aim of the study was to determine whether it is possible to differentiate submucosal fibroids before interventional procedures based on mean platelet volume (MPV), in reproductive-age patients presenting with endometrial thickening and abnormal uterine bleeding.<br />STUDY DESIGN: This study included 581 reproductive-age women who underwent diagnostic procedures (curettage or operative hysteroscopy) and were subsequently divided into two groups based on clinico-pathological findings. The first group included those with benign endometrial pathology (control group, n=438), and the second group consisted of those with submucosal leiomyomas (n=143). The demographic characteristics and complete blood count (CBC) data of these patients were collected retrospectively, and comparisons were made between groups.<br />RESULTS: No statistically significant difference was found between the groups according to demographic features and CBC parameters such as hemoglobin levels and white blood count (p&gt;0,05). Platelet counts were significantly higher and MPV values were significantly lower in submucosal leiomyoma patients compared with the control subjects (p&lt;0,05).<br />CONCLUSIONS: MPV may be a useful predictive marker when differentiating submucosal leiomyoma from other benign causes of abnormal uterine bleeding. The ability to predict the possibility of the presence of submucosal leiomyoma before surgery can assist in determining the most appropriate type of invasive procedure.</p>


Healthcare ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. 39 ◽  
Author(s):  
Emin Daldal ◽  
Hasan Dagmura

Acute appendicitis is one of the most common causes of acute abdominal diseases seen between the ages of 10 and 19, mostly seen in males. The lifetime risk of developing acute appendicitis is 8.6% for males and 6.7% for females. We aimed to investigate the efficacy of the complete blood count parameters, C-reactive protein, and Lymphocyte-C-reactive Protein Ratio laboratory tests in the diagnosis of acute appendicitis, as well as their relationship with appendix diameter. We retrospectively examined all patients who underwent appendectomy between 1 January 2012 and 30 June 2019 in the General Surgery Clinic of Gaziosmanpasa University Faculty of Medicine. Laboratory tests, imaging findings, age, and gender were recorded. Lymphoid hyperplasia is considered as normal appendix—in other words, as negative appendicitis. The distribution of Lymphoid hyperplasia and appendicitis rates were statistically different in the groups formed according to appendix diameter (≤6 and >6 mm) (p < 0.001). We found a significant correlation between appendix diameter and WBC (White blood count), Lymphocyte, Neutrophil, RDW(Red blood cell distribution width), NLR(Neutrophil to lymphocyte ratio), and PLT/L (Platelet to lymphocyte ratio), MPV (Mean platelet volume) and RDW were significantly different in patients with an appendix diameter of ≤6 mm (p = 0.007, p = 0.006, respectively). WBC, Neutrophil, PDW, and NLR values were significantly different between appendicitis and hyperplasia groups in patients with an appendix diameter of >6 mm. The sensitivity of the NLR score (cutoff = 2.6057) in the diagnosis of appendicitis was 86.1% and selectivity was 50% in these patients. Complete blood count parameters evaluation with the clinical findings revealed that NLR is an important parameter that may help the diagnosis of acute appendicitis with an appendix diameter of >6 mm. In patients whose pathological results indicated acute appendicitis but who had a diameter of ≤6 mm, we found an elevated MPV and low RDW values.


2018 ◽  
Vol 2 (3) ◽  
pp. 219
Author(s):  
Samara Ika Soegeng Prakoso ◽  
Bibit Mulyana

Background: Indonesia still facing some nutritional problems that hinder its economics development. The government itself has an effort to tackle nutritional problems by establishing  a program known as Keluarga Sadar Gizi (Kadarzi). The family expected to understand and overcome the nutritional problems affecting its members. One of Kadarzi’s five indicator is dietary diversity. Dietary divesity can reflected dietary quality. Therefore, dietary diversity assessment is influential to improve dietary quality. Objectives: The purpose of this study was to analyze the differences in dietary diversity scores among Kadarzi household. Method: The design of the study was cross sectional. Number of sample were 34 mothers who registered in Posyandu settled in Kelurahan Sidotopo, Kecamatan Semampir, Kota Surabaya. Samples were selected using simple random sampling technique. Kadarzi data were collected from KMS book. Dietary diversity was assessed using Individual Dietary Diversity Score (IDDS). The data were analyzed using independent T-test. Result: The result showed that most families were not meeting Kadarzi’s indicator (73%). There were 32.4% family categorized as low dietary diversity, 47.1% family categorized as medium dietary diversity, and 20.6% family categorized as high dietary diversity. There were a difference of dietary diversity score beetwen Kadarzi’s household nor Kadarzi’s household (p<0.001). In Kadarzi’s household the consumption of dark green leafy vegetables, other vitamin A rich fruits and vegetables, anf other fruits and vegetables are higher than non Kadarzi’s household. Conclusions: There was a significant difference in dietary diversity score beetwen Kadarzi’s household and nor Kadarzi’s household. The importance of eating diverse and some references of affordable food choice to meet dietary diversity were needed to share.ABSTRAKLatar belakang: Indonesia masih menghadapi beberapa masalah gizi yang menghambat perkembangan ekonomi. Namun pemerintah memiliki suatu upaya untuk mengatasi permasalahan gizi tersebut dengan membentuk program Keluarga Sadar Gizi (Kadarzi). Pada program ini keluarga diharapkan mampu mengerti dan mengatasi permasalahan gizi anggotanya. Salah dari lima perilaku Kadarzi adalah makan beragam. Makan beragam merupakan salah satu perilaku yang dapat menggambarkan kualitas diet individu. Oleh karena itu penilaian keragaman pangan perlu diketahui untuk mengetahui dan meningkatkan kualitas diet individu. Tujuan: Tujuan penelitian ini adalah untuk menganalisis perbedaan skor keragaman pangan pada keluarga sadar gizi. Metode: Penelitian observasional ini disusun dengan rancang bangun cross sectional. Sejumlah 34 sampel yang merupakan ibu balita yang terdaftar di Posyandu di wilayah Kelurahan Sidotopo, Kecamatan Semampir, Kota Surabaya dipilih menggunakan teknik simple random sampling. Data Kadarzi didapatkan dari observasi kartu menuju sehat (KMS). Keragaman pangan dinilai menggunakan instrumen Individual Dietary Diversity Score (IDDS). Data dianalisis menggunakan independent T-test. Hasil: Sebagian besar keluarga masih belum menerapkan perilaku Kadarzi (73%). Sebanyak 32,4% keluarga termasuk dalam kategori skor keragaman pangan rendah, 47,1% dalam kategori sedang, dan 20,6% dalam kategori tinggi. Terdapat perbedaan skor keragaman pangan antara keluarga yang menerapkan perilaku Kadarzi dan tidak menerapkan perilaku Kadarzi (p<0,001). Pada keluarga yang menerapkan perilaku Kadarzi konsumsi sayuran hijau, sayur dan buah vitamin A, sayur dan buah yang lain lebih tinggi daripada keluarga yang tidak menerapkan Kadarzi. Kesimpulan: Terdapat perbedaan skor keragaman pangan antara keluarga yang menerapkan perilaku Kadarzi dan tidak menerapkan perilaku Kadarzi. Diperlukan pemaparan informasi lebih lanjut mengenai pentingnya makan beragam dan pemilihan makanan yang terjangkau untuk dapat memenuhi konsumsi makan beragam.


Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 39-40
Author(s):  
Maria das Graças Pereira Araujo ◽  
Victor lima Soares ◽  
Alessandra Suelen Jardim Silva ◽  
Gustavo Henrique de Medeiros Oliveira ◽  
Lenilton Silva DA Silva Júnior ◽  
...  

Introduction:Sézary Syndrome (SS) is a leukemic form of Fungal Mycosis (FM), a rare form of T-cell lymphoma, characterized by erythroderma, generalized lymphadenopathy and infiltration of neoplastic T cells (Sézary cells) with cerebriform nucleus on the skin, lymph nodes and peripheral blood, being observed predominantly in men and individuals over the age of 60 and black. In the diagnosis of SS / FM, at least one of the criteria must be observed: minimum absolute Sézary cells count of 1000/mm3, expansion of TCD4+ cells with a ratio CD4/CD8 &gt;10, loss of at least one mature T cell antigens as CD2, CD3, CD5, CD7 and CD26 in associated with increased lymphocyte count with evidence of a clone of circulating TCD4 cells determined by flow cytometry (CF).Objective:To investigate MF/SS in patients diagnosed with cutaneous lymphoma by CF immunophenotyping. Methodology: Were investigated in samples of peripheral blood (SP) from 11 patients of both sexes with initial history of MF and confection of SS due to the presence of Sézary cells by cytomorphological analysis by CF constituted by a panel of conjugated monoclonal antibodies (AcMo) to fluorochromes and targeted to T lymphocytes: CD1a, CD2, CD3, CD5, CD7, subpopulation T-Helper (CD3+/CD4+) and T-cytotoxic (CD3+/CD8+), in addition to TCR a/b and TCR g/d; Natural Killer cells: CD16-56; B lymphocytes: CD19, CD20, CD21, CD22, CD23, IgM, IgG, IgD anti-kappa and anti-lambda, in addition to CD10, TdT, CD103, CD25, CD38 and CD138, CD45 and CD14. At the same time, a complete blood count with differential white blood cell count and investigation of clinical and demographic data such as age, sex and ethnicity/race were also performed. Results: Of the patients analyzed, 6/11 were male, the age group above 60 years and white individuals were also found in 6/11 patients. The blood count showed lymphocytosis in 9/11 patients with the presence of convoluted cells in all cases. The diagnosis of SS was confirmed by the presence of Sezary cells in PB counting above 1000/mm3, with an immunophenotype confirmed by the predominance of TCD4+ lymphocytes (CD4/CD8 ratio &gt; 10.0), associated with the expression of CD5, CD2, TCR a/b, CD3 weakly expressed. CD7 was absent in 10/11 samples analyzed. Antigens related to B lymphocytes and NK cells were absent in neoplastic cells as well as CD10, TdT and CD1a.Conclusions:SS is a leukemic variant of FM, characterized by exfoliative erythroderma, associated with lymphadenopathy and leukemization of FM with the appearance of Sézary cells in PB. Because it is a rare and essential disease, an accurate diagnosis of these diseases is necessary, and FC is an important diagnostic confirmation tool for SS. Disclosures No relevant conflicts of interest to declare.


2021 ◽  
Vol 9 (A) ◽  
pp. 1565-1569
Author(s):  
Harapan Parlindungan Ringoringo

BACKGROUND: Determination of the complete blood count (CBC) and reticulocyte reference range helps diagnose a disease related to changes in erythrocyte indices, white blood count, platelets, and reticulocytes, especially in newborns. AIM: The aim study is to establish a reference range for CBC and reticulocyte in healthy term newborns 1 week after birth. MATERIAL AND METHODS: The study method is prospective analyses of CBC and reticulocyte in term newborns within 1 week after birth. Inclusion criteria are term newborn (gestational age 37–42 weeks) with good tone, breathing, or crying immediately, do not have resuscitation, and the birth weight is ≥2500 g. RESULTS: Two hundred and seventy-seven term newborns met the inclusion criteria. There were 145 (52.35%) male infants and 132 (47.65%) female infants. The reference range of newborns for hemoglobin (Hb) at P2.5–P97.5, P3–P97, P5–P95, and mean ± 2 standard deviation (SD) was 11.70–19.60 g/dL, 11.90–19.57 g/dL, 12.20–19.20 g/dL, and 11.35–19.63 g/dL, respectively. In addition, reference range of male newborns for Hb at P2.5–P97.5, P3–P97, P5–P95, and mean ± 2SD was 12.20–20.14 g/dL, 12.28–19.91 g/dL, 12.63–19.38 g/dL, and 11.47–20.15 g/dL, respectively. The reference range of female newborns for Hb at P2.5–P97.5, P3–P97, P5–P95, and mean ± 2 SD was 11.37–19.20 g/dL, 11.50–19.20 g/dL, 11.80–19.20 g/dL, and 11.37–18.93 g/dL, respectively. CONCLUSION: The reference range of CBC and reticulocyte for healthy term newborns, male newborns, and female newborns in this study can be used as a benchmark.


Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 2577-2577
Author(s):  
Tamas Oravecz ◽  
Alex Turner ◽  
Philip Brown ◽  
Brian Zambrowicz ◽  
Gerd Blobel

Abstract Clinical management remains elusive for a large number of patients with hematological and other disorders necessitating the development of new, more effective pharmaceutical agents. While the sequencing of the human genome has provided a list of all drug targets that will ever exist, in order to improve the speed and cost of drug development there is a critical need to identify the small subset of these targets whose modulation will lead to therapeutic outcomes. As a genetic model of a perfectly selective and potent chemical antagonist, the analysis of the phenotypes of knockout mice allows one to predict the mechanism based efficacy and side effect profile of modulators of a particular target in a physiologic mammalian setting without having to first develop a candidate drug with which to validate the target. The power of this approach has been demonstrated by studies examining the targets of the best-selling drugs and current pharmaceutical pipelines. These analyses have confirmed a strong (~85%) correlation between the target’s knockout phenotype and the efficacy and/or side effects of drugs that modulate them. We have implemented this target validation approach by developing systems and infrastructure to generate and comprehensively phenotype mutant mice at a rate of more than fifteen novel lines per week. The battery of tests encompassed by our analysis have been specifically selected to reveal those genes that encode key control points in mammalian physiology whose modulation may be used to treat major disease processes including hematologic disorders. Tests to detect hematologic phenotypes include complete blood count; immunophenotyping; blood chemistry; analysis of soluble factors (immunoglobulins, cytokines and inflammatory mediators); full histopathologic examination, and various in vivo and in vitro immune challenge and cell activation assays. In addition, selected lines are subjected to more extensive analyses including additional challenge assays, gene expression profiling, and bone marrow transplantation. Data will be presented describing one of the lines analyzed in this screen, the Abl2 knockout, which has an increased mean total white blood count relative to wild-type littermates, as well as smaller body size (decreased length and weight). In parallel with the identification of therapeutically relevant proteins, we are actively exploring pharmacologic methods, both with small molecules and therapeutic antibodies, to modify the function of these novel gene targets, and ultimately to treat human disease.


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