scholarly journals Assessment of Malnutrition, Sarcopenia and Frailty in Patients with Cirrhosis: Which Tools Should We Use in Clinical Practice?

Nutrients ◽  
2020 ◽  
Vol 12 (1) ◽  
pp. 186 ◽  
Author(s):  
Benjamin Buchard ◽  
Yves Boirie ◽  
Lucie Cassagnes ◽  
Géraldine Lamblin ◽  
A. Coilly ◽  
...  

Malnutrition is a common comorbidity in patients with cirrhosis. Its prognostic value is indisputable as it greatly affects the evolution of liver diseases. It has a major impact on both morbi-mortality before and after liver transplantation. Being now integrated in the definition of malnutrition and recognized as a new entity in the international classification of diseases, physicians have taken great interest in sarcopenia. Its negative consequences on the fate of patients with cirrhosis are well-demonstrated. The concept of frailty has recently been enlarged to chronic liver diseases as symptoms of impaired global physical functioning. In this article, we will discuss the definitions of malnutrition and emphasize its links with sarcopenia and frailty. We will show the relevance of frailty and sarcopenia in the course of liver diseases. The emerging role of muscle depletion on the cardiorespiratory system will also be highlighted. The importance of body composition will be demonstrated and the main tools reviewed. Finally, we adapted the definition of malnutrition to patients with cirrhosis based on the assessment of sarcopenia together with reduced food intakes.

2021 ◽  
Vol 10 (13) ◽  
pp. e571101321391
Author(s):  
Dayane da Rocha Pimentel ◽  
Rosário Antunes Fonseca Lima ◽  
Mirian Domingos Cardoso ◽  
Conceição Maria de Oliveira ◽  
Cristine Vieira do Bonfim

Objective: To analyze the improvement of the definition of the underlying cause of neonatal deaths before and after death surveillance in Recife, Pernambuco. Methods: A descriptive study that used data from medical certificates of death, confidential data sheets, summaries of investigations. The profiles and the relocation of the underlying cause of death were compared before and after the investigation through specific chapters and groups of the Tenth Revision of the International Classification of Diseases. The agreement was analyzed using the Kappa index. Results: Of the total 144 deaths investigated, 95 (66.0%) had their underlying cause redefined. During the general analysis of the neonatal component, a reasonable agreement index was identified (0.311; CI95%: 0.272-0.350). All ill-defined causes were clarified after surveillance. There was an increment of the preventability potential for all neonatal deaths, with an emphasis on early deaths, which reached 100% causes registered as preventable. Conclusion: Death surveillance made it possible to improve the specificity of the underlying causes described in the medical certificate of death and may contribute to the reorientation of the strategies to reduce neonatal mortality from the perspective of preventability.


Entropy ◽  
2018 ◽  
Vol 20 (10) ◽  
pp. 769 ◽  
Author(s):  
Donghua Chen ◽  
Runtong Zhang ◽  
Xiaomin Zhu

This study aimed to propose a mapping framework with entropy-based metrics for validating the effectiveness of the transition between International Classification of Diseases 10th revision (ICD-10)-coded datasets and a new context of ICD-11. Firstly, we used tabular lists and mapping tables of ICD-11 to establish the framework. Then, we leveraged Shannon entropy to propose validation methods to evaluate information changes during the transition from the perspectives of single-code, single-disease, and multiple-disease datasets. Novel metrics, namely, standardizing rate (SR), uncertainty rate (UR), and information gain (IG), were proposed for the validation. Finally, validation results from an ICD-10-coded dataset with 377,589 records indicated that the proposed metrics reduced the complexity of transition evaluation. The results with the SR in the transition indicated that approximately 60% of the ICD-10 codes in the dataset were unable to map the codes to standard ICD-10 codes released by WHO. The validation results with the UR provided 86.21% of the precise mapping. Validation results of the IG in the dataset, before and after the transition, indicated that approximately 57% of the records tended to increase uncertainty when mapped from ICD-10 to ICD-11. The new features of ICD-11 involved in the transition can promote a reliable and effective mapping between two coding systems.


2007 ◽  
Vol 5 (10) ◽  
pp. 1081-1091 ◽  
Author(s):  
William Breitbart ◽  
Yesne Alici-Evcimen

Fatigue is a common and highly distressing symptom of cancer associated with reduced quality of life and considerable psychological and functional morbidity. The reported prevalence of cancer-related fatigue ranges from 4% to 91%, depending on the specific cancer population studied and the methods of assessment. Cancer-related fatigue has typically been underreported, underdiagnosed, and undertreated. Fatigue and depression may coexist in cancer patients, and considerable overlap of symptoms occurs. This is partly the reason for the interest in examining the role of psychotropic medications in treating fatigue. Clarifying the relationship between depression and fatigue is necessary to effectively evaluate and treat cancer-related fatigue. Even with International Classification of Diseases criteria, differentiating cancer-related fatigue is difficult. Psychotropic drugs that have been studied for cancer-related fatigue include psychostimulants, wakefulness-promoting agents, and anti-depressants. Methylphenidate has been studied most and seems to be effective and well tolerated despite common side effects. Some preliminary data support using modafinil in cancer-related fatigue with less concern about tolerance or dependence. Antidepressant studies have shown mixed results. Paroxetine seems to show benefit for fatigue primarily when it is a symptom of clinical depression. Bupropion, a norepinephrine/dopamine reuptake inhibitor, may have psychostimulant-like effects, and therefore may be more beneficial for treating fatigue. However, studies are currently limited. Randomized, placebo-controlled trials with specific agents are needed to further assess the efficacy and tolerability of psychotropic medications in the treatment of cancer-related fatigue.


2017 ◽  
Vol 25 (6) ◽  
pp. 287-290 ◽  
Author(s):  
GIOVANNA DAMM RAPHAEL JUNQUEIRA ◽  
ANDRÉ LUIZ MACHADO LIMA ◽  
ROBISON BONI ◽  
JOELMAR CÉSAR DE ALMEIDA ◽  
RAFAEL SOUZA RIBEIRO ◽  
...  

ABSTRACT Objectives: A retrospective statistical data gathering of wrist and hand complaints assisted over two years in the orthopedic emergency department of a regional referral hospital, seeking to know the profile of these patients. Methods: Information obtained by analysis of 31.356 orthopedic visits from May 2013 to April 2015, of which 6.754 related to hand complaints and/or wrist, at the Hospital Estadual Doutor Jayme dos Santos Neves (HDJSN) and analyzed by IBM SPSS Statistics software version 21. Results: The data revealed that the average age was 37,5 ± 15,7 years and the male gender was predominant (60,72%). Bruises (52,58%) and fractures (30,49%) were the most common diagnoses. Conclusion: The complaints of wrist and hand accounted for 21,44% of all orthopedic emergency room visits. Detailed data description and correct definition of the International Classification of Diseases (ICD-10) are needed to better define the epidemiological profile of patients seeking orthopedic emergency. Level of Evidence III, Retrospective Study.


2017 ◽  
Vol 28 (4) ◽  
pp. 363-387
Author(s):  
Kristine Jensen de López ◽  
Hanne Søndergaard Knudsen ◽  
Tia G. B. Hansen

Objective Childhood bereavement from parental death can be a significant stressor. Treatment studies vary largely on how the effect of the grief treatment is measured. This sytematic review evaluates whether controlled bereavement intervention studies focus on symptomatalogy or grief as outcome measure and also summarizes the effect of grief treatment. Method For inclusion in the review, studies must report on children or adolesecents who experienced the death of a parent or sibling, must have a control group and must report results of a grief treatment. Results Eight studies met the inclusion criteria and reported in total on 30 different outcome measures. Only two studies measured grief as a separate outcome and both showed promising results for the treatment of grief with bereaved children. Conclusions Systematic use of validated measures of prolonged grief in treatment studies is needed. Implications of the findings and recommendations for future studies are discussed in the perspective of complicated grief becoming part of the 11th Revision of the International Classification of Diseases. Grief interventions for parentally bereaved youth is promising but lack consistent use of reliable grief measures for solid documentation of the effect. The specific role of parenting and culture for the outcome of the intervention should be investigated in more detail.


Author(s):  
David Cheng ◽  
Clark DuMontier ◽  
Cenk Yildirim ◽  
Brian Charest ◽  
Chelsea E Hawley ◽  
...  

Abstract Background The Veterans Affairs Frailty Index (VA-FI) is an electronic frailty index developed to measure frailty using administrative claims and electronic health records data in Veterans. An update to ICD-10 coding is needed to enable contemporary measurement of frailty. Method International Classification of Diseases, ninth revision (ICD-9) codes from the original VA-FI were mapped to ICD-10 first using the Centers for Medicaid and Medicare Services (CMS) General Equivalence Mappings. The resulting ICD-10 codes were reviewed by 2 geriatricians. Using a national cohort of Veterans aged 65 years and older, the prevalence of deficits contributing to the VA-FI and associations between the VA-FI and mortality over years 2012–2018 were examined. Results The updated VA-FI-10 includes 6422 codes representing 31 health deficits. Annual cohorts defined on October 1 of each year included 2 266 191 to 2 428 115 Veterans, for which the mean age was 76 years, 97%–98% were male, 78%–79% were White, and the mean VA-FI was 0.20–0.22. The VA-FI-10 deficits showed stability before and after the transition to ICD-10 in 2015, and maintained strong associations with mortality. Patients classified as frail (VA-FI > 0.2) consistently had a hazard of death more than 2 times higher than nonfrail patients (VA-FI ≤ 0.1). Distributions of frailty and associations with mortality varied with and without linkage to CMS data and with different assessment periods for capturing deficits. Conclusions The updated VA-FI-10 maintains content validity, stability, and predictive validity for mortality in a contemporary cohort of Veterans aged 65 years and older, and may be applied to ICD-9 and ICD-10 claims data to measure frailty.


Author(s):  
Mateusz Gola ◽  
Karol Lewczuk ◽  
Marc N. Potenza ◽  
Drew A. Kingston ◽  
Joshua B. Grubbs ◽  
...  

AbstractCompulsive sexual behavior disorder (CSBD) is currently defined in the eleventh revision of the International Classification of Diseases (ICD-11) as an impulse control disorder. Criteria for hypersexual disorder (HD) had been proposed in 2010 for the fifth revision of Diagnostic and Statistical Manual (DSM-5). In this article, we compare differences between HD and CSBD and discuss their relevance.Significant differences between HD and CSBD criteria include: (1) the role of sexual behavior as a maladaptive coping and emotion regulation strategy listed in criteria for HD but not in those for CSBD; (2) different exclusionary criteria including bipolar and substance use disorders in HD but not in CSBD, and (3) inclusion of new considerations in CSBD, such as moral incongruence (as an exclusion criterion), and diminished pleasure from sexual activity. Each of these aspects has clinical and research-related implications. The inclusion of CSBD in the ICD-11 will have a significant impact on clinical practice and research. Researchers should continue to investigate core and related features of CSBD, inlcuding those not included in the current criteria, in order to provide additional insight into the disorder and to help promote clinical advances.


1998 ◽  
Vol 26 (2) ◽  
pp. 219-259
Author(s):  
Norman Q. Brill

In 1973 the American Psychiatric Association removed homosexuality from its list of diagnoses, thereby implying that it is a normal variant of sexual behavior. Since then, when homosexuals have sought professional help for emotional problems, psychiatrists have tended increasingly to assist them to believe that their emotional discomfort is the result of society's bias and intolerance and to accept and enjoy their preference for individuals of the same sex. The World Health Organization, however, still includes homosexuality as a medical diagnosis in the International Classification of Diseases. Normally, a child can be expected to develop into an adult with its genetically determined sex. When a boy who is physically and hormonally normal develops a preference for sex with another male, it is an indication that something is amiss. A pathologic family environment is often present in the family of homosexuals. Yet not all boys exposed to a pathologic family during early development become homosexuals. Because of this, the role of disturbed relationships in causing homosexuality is questioned. However, psychoanalyses of male homosexuals have convincingly revealed the existence of a fear of heterosexuality in individuals with genetically predisposed personalities.


Author(s):  
SAID EL MADIDI

Introduction: Congenital malformations are a global health problem around the world. MCs is one of the main causes of death and disability of newborns worldwide, but the majority of its risk factors are still poorly understood. Objective: The aim of this study is to determine the main causes that are related to the incidence of congenital malformations (CMs) in the region of Agadir in Morocco. Material and Methods: A prospective cases-control study at regional level was conducted in the pediatrics and neonatology department of Hassan II hospital in Agadir from April 2016 to April 2018. Data on child and maternal variables were recorded for 3701 newborns. The types of congenital malformations  have been classified according to the codes of the International Classification of Diseases. Univariate analyzes were performed to identify the variables associated with the etiology of the malformations. Multiple logistic regression was used to characterize the associations between the MC and the determining explanatory variables taken into account simultaneously. Results: The results of these studies showed that there is a significant association between the incidence of the Congenital anomalies and the level of the consanguinity of the child, the prematurity of childbirth, the family history of CMs, the body mass index of the mother and the presence of major trauma during pregnancy. Conclusion: our results have made it possible to highlight the existence of an association between a certain number of risk factors and the occurrence of congenital malformations. Additional studies are needed to confirm and clarify the role of these risk factors.


Author(s):  
Jan Willer

Understanding the symptoms of adult ADHD is an essential starting place. Diagnostic and Statistical Manual of Mental Disorders symptoms of ADHD are reviewed, including inattention/distractibility, impulsiveness, and hyperactivity, as well as other adult ADHD symptoms that have been well documented in multiple research studies. Suggested interview questions for each symptom are presented. Additional adult ADHD symptoms include executive functioning deficits, emotional dysregulation, atypical reward sensitivity, and time perception differences. Sluggish cognitive tempo is also defined and a case example given. Last, progress towards a new definition of ADHD is presented, and the practicalities of diagnosing ADHD using the International Classification of Diseases, 10th Revision, are discussed.


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