scholarly journals Study of prevalence for lactose malabsorption in malnutrition

2018 ◽  
Vol 6 (10) ◽  
pp. 3202
Author(s):  
Sameer Kumar Painkra ◽  
Dhannu Ram Mandavi
Keyword(s):  
Body Weight ◽  
Protein Energy Malnutrition ◽  
Indian Academy ◽  
Severe Malnutrition ◽  
Contributory Factor ◽  
Lactose Malabsorption ◽  
Lactose Tolerance ◽  
Protein Energy ◽  
Tolerance Curve

Background: Milk is the major food in the diet of the infant mammal and consequently has always attracted considerable interest from the physician, the industrialist and the mother. The concentration of lactose in milk varies from species to species. Main objective is to study the prevalence of malabsorption in malnutrition.Methods: Sixty-seven children ranged between ages of 6 months to 3 years, of both sex and varying grades of malnutrition, were studied. Study conducted between July 1979-December 1979. All children were grouped into 4 grades of malnutrition according to Indian Academy of Pediatrics recommendation.Results: Out of 67 cases, 50 were followed up. Severe malnutrition of grades III and IV (less than 60 percent of expected body weight) comprises 58.2 percent (39 out of 67) in first seen group, and 52 percent (26 out of 50) in follow up group. 59.7 percent Males and 40.3 percent females in first seen cases. 58 percent males and 42 percent females in follow up cases. 24 cases (53.33 percent) of lactose malabsorbers were males and 21 cases (46.67 percent) were females.Conclusions: Lactose malabsorption is common in protein-energy malnutrition. This can be determined by simple ward tests and abnormal lactose tolerance curve after oral lactose load. Lactose malabsorption increases with the severity of malnutrition. Malnutrition leads to lactose malabsorption and lactose malabsorption is an important contributory factor in production of malnutrition.

scholarly journals Prealbumin Serum Concentrations as a Useful Tool in the Assessment of Malnutrition in Hospitalized Patients

2006 ◽  
Vol 52 (12) ◽  
pp. 2281-2285 ◽  
Author(s):  
Gianluigi Devoto ◽  
Fabrizio Gallo ◽  
Concetta Marchello ◽  
Omar Racchi ◽  
Roberta Garbarini ◽  
...  
Keyword(s):  
Nutritional Assessment ◽  
Protein Energy Malnutrition ◽  
Reference Method ◽  
Hospitalized Patients ◽  
Severe Malnutrition ◽  
Serum Concentrations ◽  
Nutritional Index ◽  
Protein Energy ◽  
Sensitivity Specificity ◽  
Worse Prognosis

Abstract Background: Protein-energy malnutrition (PEM) is a common condition among patients admitted to hospitals, and it is associated with a worse prognosis and increased mortality. Although several screening systems have been developed, PEM is still poorly recognized, and there is no consensus on which test is more reliable and feasible in clinical practice. Prealbumin (PAB) is a potential useful PEM marker because its serum concentrations are closely related to early changes in nutritional status. Methods: We studied PEM prevalence and PAB serum concentrations in 108 hospitalized patients. The Detailed Nutritional Assessment (DNA) was used as the reference method to determine PEM. PAB performance was compared with that of 2 other methods, the Subjective Global Assessment (SGA) and the Prognostic Inflammatory and Nutritional Index score (PINI). Results: According to the DNA reference method, 41% of patients were classified with mild malnutrition and 19% with severe malnutrition. PAB showed the best concordance with the standard DNA method (concordance index, 76.8%) and a good sensitivity/specificity profile (83.1%/76.7%) compared with SGA and PINI. Conclusions: We conclude that PAB could represent a feasible and reliable tool in the evaluation of malnutrition, especially in settings where it is difficult to obtain a more detailed and comprehensive nutritional assessment such as the DNA.

scholarly journals Weight loss in an obese child: positive changes or not?

2021 ◽  
pp. 152-161
Author(s):  
A. Yu. Vаshura
Keyword(s):  
Weight Loss ◽  
Body Composition ◽  
Body Weight ◽  
Obese Child ◽  
Protein Energy Malnutrition ◽  
Fat Free Mass ◽  
Healthy Population ◽  
Negative Consequences ◽  
Protein Energy ◽  
The One

Weight, BMI and its changes with age are one of the key indicators in pediatrics. The values of these indicators are the main parameters for assessing nutritional status (NS) and defining nutritional disorders - obesity and protein-energy malnutrition. At the same time, body weight and its changes only conditionally reflect the mass of fat and the amount of fat-free mass (especially the compartment of skeletal muscles). In the healthy population (in which the relevant references had been obtained), the changes of BMI can significantly reflect the changes of body composition. In children with chronic diseases (and/or with metabolic disorders, and/ or in oncopediatrics) the sensitivity of BMI as an indicator of NS is significantly lower and variable. This is due to deviations from the “normal” body composition existing in these patients. As a result, a deficit of fat-free mass can be accompanied by an excess of fat mass. Sarcopenia, which has negative consequences for the child, can be masked by obesity. Therefore, this condition, sar-copenic obesity, represents a huge problem. On the one hand, due to the coexistence of two nutritional disorders in one patient. On the other hand, due to underestimation in pediatrics. The latter is the consequence of frequent understanding of the child’s body weight as an unconditional and independent indicator. This can have dramatic consequences for the development and growth of the child. Therefore, weight loss in an obese child does not yet mean positive dynamics.

scholarly journals Efficiency of post-dilution online hemodiafiltration therapy in combination with ketoanalogues of amino acid in the correction of protein-energy malnutrition in hemodialysis patients

2018 ◽  
pp. 174-178 ◽  
Author(s):  
A. A. Yakovenko
Keyword(s):  
Body Weight ◽  
Amino Acid ◽  
Protein Energy Malnutrition ◽  
Ideal Body Weight ◽  
Hemodialysis Patients ◽  
Adequate Intake ◽  
Essential Nutrients ◽  
Protein Energy ◽  
Ideal Body ◽  
Keto Analogues

Purpose of the study. Evaluate the efficiency of permanent post-dilution online hemodiafiltration therapy in combination with the prescription of keto analogues of amino acid at a dose of 0,2 g/kg of ideal body weight/day to correct protein-energy malnutrition in hemodialysis patients with adequate intake of essential nutrients. Patients and methods. A total of 645 patients with terminal renal failure received programmed hemodialysis, of which there were 300 men and 345 women aged 58,8 ± 6,9 years. All patients received treatment with programmed GD for 6,9 ± 2,1 years. All patients underwent a comprehensive assessment of nutritional status. The level of leptin and interleukin-6 serum was determined. Patients with signs of protein-energy malnutritian (PEM) were divided into three groups, depending on the method of PEM correction. Results. The study showed the efficiency of postdilution online hemodiafiltration therapy on an ongoing basis in combination with keto-analogues of amino acids at a dose of 0,2 g/kg of ideal body weight/day for correction of PEM in hemodialysis patients. Conclusion. The post-dilution online hemodiafiltration therapy combined with keto-analogues of amino acid at a dose of 0.2 g /kg of ideal body weight/day can be considered one of the pathogenetically grounded methods for correcting PEM in patients receiving programmed hemodialysis with adequate intake of essential nutrients. 

P786Plasma volume status is associated with the change in nutritional status during hospitalization in acute decompensated heart failure patients with preserved left ventricular ejection fraction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Tamaki ◽  
T Yamada ◽  
T Morita ◽  
Y Furukawa ◽  
M Fukunami ◽  
...  
Keyword(s):  
Heart Failure ◽  
Body Weight ◽  
Nutritional Status ◽  
Multivariate Logistic Regression Analysis ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Severe Malnutrition ◽  
Operating Characteristics ◽  
Ventricular Ejection Fraction

Abstract Introduction Plasma volume (PV) expansion has an essential role in heart failure (HF). PV can be estimated by a simple formula using hematocrit and body weight, and PV status (PVS) provides prognostic information in patients (pts) with chronic HF. Nutritional status (NS) based on the prognostic nutritional index (PNI) and NS change during hospitalization have been shown to predict prognosis in pts admitted with acute decompensated HF (ADHF). Purpose We sought to assess the hypothesis that PVS is associated with NS change during hospitalization in pts with HF with preserved LVEF (HFpEF) who are admitted with ADHF. Methods We prospectively studied 411 pts who were admitted for ADHF with LVEF ≥50% and survived to discharge. Body weight measurement and venous blood sampling were performed on admission and at discharge. PVS was defined as follows: actual PV = (1 − hematocrit) × [a + (b × body weight)] (a=1530 in males and a=864 in females, b=41.0 in males and b=47.9 in females); ideal PV = c × body weight (c=39 in males and c=40 in females); and PVS = [(actual PV − ideal PV)/ideal PV] × 100 (%). PNI was calculated as 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (per mm3). The pts were divided into 3 groups by PNI: normal (>38), moderate malnutrition (35–38), and severe malnutrition (<35). During admission, pts who remained in the moderate or severe malnutrition group or whose NS worsened were defined as no improvement in NS. Follow-up data was obtained in 203 cases. They were followed for up to 18 months, and the incidence of all-cause death was evaluated. Results On admission, PVS in the moderate (n=71, 13.3±13.9%) or severe malnutrition group (n=69, 14.8±10.8%) was significantly higher than in the normal PNI group (n=271, 5.4±10.8%, p<0.001). During hospitalization, 123 pts had no NS improvement. Admission PVS was significantly higher in pts with no NS improvement than in pts with improved NS (13.9±11.2% vs 5.9±12.8%, p<0.0001). In multivariate logistic regression analysis, admission PVS was independently associated with no NS improvement during hospitalization (OR 1.06, 95% CI 1.03–1.08, p<0.0001). Receiver operating characteristics curve analysis revealed that the optimal cut-off value of admission PVS for predicting no NS improvement was 9.4% (sensitivity: 72%, specificity: 63%). The area under the curve for predicting no NS improvement using admission PVS was significantly greater than for other independent factors (Figure 1A). During the follow-up period (median 12.4 months), 68 of 203 patients had all-cause death. Kaplan-Meier analysis showed that the patients with no NS improvement had a significantly higher risk of all-cause death (Figure 1B). Figure 1 Conclusions In this multicenter study, admission PVS was shown to be associated with poor improvement in NS during hospitalization in HFpEF pts admitted for ADHF. Acknowledgement/Funding Roche diagnostics, FUJIFILM Toyama Chemical

Mortality Risk Factors in Acute Protein-Energy Malnutrition

1989 ◽  
Vol 19 (2) ◽  
pp. 82-85 ◽  
Author(s):  
S J Gillam
Keyword(s):  
Socioeconomic Factors ◽  
Protein Energy Malnutrition ◽  
Severe Malnutrition ◽  
Admission Criteria ◽  
Nutritional Rehabilitation ◽  
Factors Associated ◽  
Protein Energy ◽  
Suspected Tuberculosis ◽  
Save The Children ◽  
High Risk Children

The records of 45 children admitted to the Save The Children Fund (UK) Clinic, Dhankuta, East Nepal for nutritional rehabilitation, and who subsequently died, were compared with those of 200 survivors admitted during the same period. Children who died were more likely to have attended the clinic previously (P<0.02), and tended to be younger and lighter than controls. A poor outcome was associated with oedema (P< 0.02), hepatomegaly (P<0.01), suspected tuberculosis (P<0.001) and various socioeconomic factors: children who died came from larger families, ‘single parent’ families (P< 0.01), and were more likely to have lost a sibling (P< 0.01). The irrigated landholdings of dying children's families were on average approximately half the size of those of survivors' families. These socioeconomic factors were associated with more severe malnutrition at presentation. The identification of factors associated with a poor prognosis can help to focus admission criteria and to monitor especially high-risk children where services for the acutely malnourished are limited.

scholarly journals Drug disposition in obesity and protein–energy malnutrition

2010 ◽  
Vol 69 (4) ◽  
pp. 543-550 ◽  
Author(s):  
Joseph I. Boullata
Keyword(s):  
Body Composition ◽  
Body Weight ◽  
Obese Patient ◽  
Drug Disposition ◽  
Protein Energy Malnutrition ◽  
Nutrition Status ◽  
Rational Approach ◽  
Drug Elimination ◽  
Related Factors ◽  
Protein Energy

Clinical response to medication can differ between patients. Among the known sources of variability is an individual's nutrition status. This review defines some pharmacokinetic terms, provides relevant body size metrics and describes the physiologic influences of protein–energy malnutrition and obesity on drug disposition. Weight-based drug dosing, which presumes a healthy BMI, can be problematic in the protein–energy malnourished or obese patient. The use of total body weight, lean body weight, or an adjusted body weight depends on the drug and how it is differently handled in malnutrition or obesity. Most of the recognized influences are seen in drug distribution and drug elimination as a result of altered body composition and function. Distribution characteristics of each drug are determined by several drug-related factors (e.g. tissue affinity) in combination with body-related factors (e.g. composition). Drug elimination occurs through metabolic and excretory pathways that can also vary with body composition. The current data are limited to select drugs that have been reported in small studies or case reports. In the meantime, a rational approach to evaluate the potential influences of malnutrition and obesity can be used clinically based on available information. Antimicrobials are discussed as a useful example of this approach. Further advancement in this field would require collaboration between experts in body composition and those in drug disposition. Until more data are available, routine monitoring by the clinician of the protein–energy malnourished or obese patient receiving weight-based drug regimens is necessary.

scholarly journals TYPICAL DERMATOSIS IN KWASHIORKOR

2017 ◽  
Vol 10 (8) ◽  
pp. 3 ◽  
Author(s):  
Madan Gopal Rajan ◽  
Rukmini M S ◽  
Sulekha Sinha ◽  
Anupama Hegde ◽  
Poornima Manjrekar
Keyword(s):  
Developing Countries ◽  
Nutritional Support ◽  
Protein Energy Malnutrition ◽  
Family Health ◽  
Skin Lesions ◽  
Severe Malnutrition ◽  
National Family Health Survey ◽  
Protein Energy ◽  
National Family ◽  
Dermatologic Manifestations

Protein-energy malnutrition is the most widespread nutritional deficiency disorder in India, commonly occurring in children aged 6 months-2 years,as per the National Family Health Survey, 2007. The dermatologic manifestations are more florid and characteristic in kwashiorkor than in marasmus.Here, we present a case of a 1½ years old male, with extensive skin lesions, owing to severe malnutrition. Malnourishment is one of the foremostconditions seen in the developing countries. It is essential to provide adequate nutritional support to the growing children and to impart proper education to the mothers with regard to weaning and care during the illness of children aged under 5 years.

Impact of protein energy malnutrition on Trichuris suis infection in pigs concomitantly infected with Ascaris suum

Parasitology ◽  
2002 ◽  
Vol 124 (5) ◽  
pp. 561-568 ◽  
Author(s):  
S. PEDERSEN ◽  
I. SAEED ◽  
K. F. MICHAELSEN ◽  
H. FRIIS ◽  
K. D. MURRELL
Keyword(s):  
Body Weight ◽  
Packed Cell Volume ◽  
Ascaris Suum ◽  
Protein Energy Malnutrition ◽  
Trichuris Suis ◽  
Intestinal Nematode ◽  
Low Protein ◽  
Protein Energy ◽  
Protein Diets ◽  
Eosinophil Counts

The objective of this experiment was to investigate a possible interaction between protein and energy malnutrition (PEM) and intestinal nematode infections. We report on a 3×2 factorial study in which pigs were fed either a low protein energy (LPE), low protein (LP) or a normal protein energy (NPE) diet, and 6 weeks later inoculated with Trichuris suis (4000 infective eggs). Secondarily, in order to obtain a polyparasitic status, pigs were concomitantly inoculated with Ascaris suum (600 infective eggs). The number of T. suis-infected pigs was higher in LP pigs compared with NPE pigs (100 versus 58%; P = 0·037), although the differences in median T. suis worm burdens between groups at necropsy 10 weeks post-infection (p.i.) (LPE: 795; LP: 835; NPE: 48 worms; P = 0·33) were not significant. Interestingly, only T. suis in NPE were highly aggregated (k = 0·44), in contrast to a more uniform distribution among pigs in LPE (k = 1·43) and LP (k = 1·55) i.e. the majority of pigs harboured moderate worm burdens in LPE and LP, while most pigs had few or no worms in NPE. Further, T. suis worms in the LPE and LP groups were decreased in length (mean: LPE: 23·5 mm; LP: 24·3 mm; NPE: 29·4 mm; P = 0·004). The pre-patency period of T. suis was also extended in the LPE and LP groups, as reflected by lower faecal egg output at week 6 (P = 0·048) and/or 7 p.i. (P = 0·007). More A. suum worms were recovered from LP compared with the NPE group (mean: 5·4 versus 0·6; P = 0·040); this was accompanied by a higher faecal egg output in the former (P = 0·004). The low protein diets resulted in lower pig body weight gains, serum albumin, haemoglobin and packed cell volume (PCV) levels as well as diminished peripheral eosinophil counts. Infection significantly altered these parameters in the low protein groups, i.e. the pathophysiological consequences of infection were more severe in the PEM pigs. These results demonstrate that reduced protein in the diet leads to malnourishment of both the host pigs and T. suis, and compromises the pig's ability to resist infection by T. suis and A. suum.

scholarly journals Nutritional evaluation of stage 5 chronic kidney disease patients on dialysis

2012 ◽  
Vol 130 (6) ◽  
pp. 392-397 ◽  
Author(s):  
Cynthia Mauro Piratelli ◽  
Rodolpho Telarolli Junior
Keyword(s):  
Protein Energy Malnutrition ◽  
Chronic Kidney Failure ◽  
Cross Sectional Study ◽  
Severe Malnutrition ◽  
Upper Arm ◽  
Cross Sectional ◽  
Treatment Unit ◽  
Protein Energy ◽  
Nutritional Monitoring ◽  
The Ideal

CONTEXT AND OBJECTIVE: Patients with chronic kidney failure undergoing dialysis have high prevalence of protein-energy malnutrition. There is still no uniform method for assessing these patients' nutritional status. It is recommended that a set of subjective and objective methods should be applied so that an adequate nutritional diagnosis can be reached. The aim of this study was to evaluate the nutritional profile of patients undergoing hemodialysis. DESIGN AND SETTING: Cross-sectional study conducted in the Dialysis Treatment Unit, Araraquara, São Paulo, Brazil, in 2008. METHODS: Anthropometric and biochemical indicators were characterized for 48 patients who also gave responses to the modified Subjective Global Assessment questionnaire (SGAm), and possible correlations between these indicators were investigated. RESULTS: The frequency of moderate or severe malnutrition ranged from 22% to 54%, according to the parameter used. Regarding the patients' conformity with the ideal weight, 29% of them weighed less than 75% of the ideal, and thus were classified as having moderate or severe malnutrition. The most significant correlations were observed between body mass index (BMI) and the idealness of triceps skinfold (TSF), upper arm circumference (UAC) and upper arm muscle circumference (UAMC); and between SGAm and the idealness of UAC and UAMC. CONCLUSION: The frequency of malnutrition showed great variability among the patients, according to the evaluation criterion chosen. Routine nutritional monitoring and validation of methods for assessing body composition among such patients are extremely important for diagnosing malnutrition early on, thus preventing complications and reducing the morbidity and mortality rates in this population.

scholarly journals Serum albumin and transferrin in protein-energy malnutrition: Their use in the assessment of marginal undernutrition and the prognosis of severe undernutrition

1976 ◽  
Vol 36 (2) ◽  
pp. 255-263 ◽  
Author(s):  
P. J. Reeds ◽  
A. A. O. Laditan
Keyword(s):  
Serum Albumin ◽  
Protein Energy Malnutrition ◽  
Severe Malnutrition ◽  
Serum Transferrin ◽  
Malnourished Children ◽  
Protein Energy ◽  
The Mean ◽  
Index Of Severity ◽  
Mean Concentration ◽  
Made In

1. Deficits in weight- and length-for-age, and serum albumin and transferrin concentrations were determined for children who were either marginally undernourished (twenty-five children) or suffering from either marasmus (thirty-two children) or kwashiorkor (twenty-six children) defined according to the Wellcome Classification (Waterlow, 1972). The measurements were also made in eight children with kwashiorkor after the loss of oedema, and in sixteen children who were recovering from either marasmus or kwashiorkor.2. The mean concentration of serum albumin was similar for children from the ‘under-nourished’ group and from the group with marasmus, but was significantly reduced in those with kwashiorkor.3. The concentration of serum transferrin was significantly reduced in both the group of children with marasmus and those with kwashiorkor. The serum transferrin concentration was significantly lower in children with kwashiorkor when compared with the level in those with marasmus.4. Seventeen children (seven with kwashiorkor and ten with marasmus) died. These children were neither lighter nor shorter than the severely malnourished children who survived. The concentration of serum albumin was not lower in the children who died than in those who survived.5. In contrast to the results for serum albumin concentrations, the children who died had significantly lower levels of serum transferrin than those who survived.6. There was a significant linear relationship between serum transferrin concentrations and the deficits in length-for-age (P < 0·05) and weight-for-length (P < 0·001) in the marginally undernourished children. The deficit in weight-for-length was also linearly related to the serum transferrin concentrations (P < 0·001) in children recovering from severe malnutrition.7. It is suggested that the measurement of serum transferrin concentrations provides an index of severity in severely malnourished children, and should prove useful in field assessments of nutritional status.

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