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2021 ◽  
Vol 11 ◽  
Author(s):  
Jikuan Jin ◽  
Guangbing Xiong ◽  
Xiaoxiang Wang ◽  
Feng Peng ◽  
Feng Zhu ◽  
...  

PurposeThe aim of this study was to investigate the effect of preoperative and postoperative malnutrition on postoperative short- and long-term outcomes for ampullary carcinoma after pancreatoduodenectomy (PD).MethodsData were collected retrospectively from 511 patients with ampullary carcinoma who underwent PD between June 2012 and June 2019. Nutritional status before and at 3, 6, and 12 months after operation was assessed by the scored Patient-Generated Subjective Global Assessment (PG-SGA). The patients were classified into well-nourished, moderately malnourished, and severely malnourished group according to the PG-SGA score. Propensity score matching (PSM) was performed to adjust baseline characteristics between preoperative group A (well-nourished and moderately malnourished group) and group B (severely malnourished group). After PSM, clinicopathological variables and postoperative complications were compared between the two groups. Univariate and multivariate Cox analysis was also conducted to investigate the prognostic factors of overall survival of patients with ampullary carcinoma who underwent PD.ResultsPreoperatively, 122 (23.9%) patients were classified into well-nourished group, 189 (37.0%) into moderately malnourished group, and 200 (39.1%) into severely malnourished group. After PSM analysis, the incidence of overall postoperative complications was higher in group B than that in group A (50.5% vs. 32.5%, p < 0.001). Multivariate Cox proportional hazards regression model showed that severe malnutrition (PG-SGA score >9 scores) before operation [hazard ratio (HR) = 1.508; 95% CI, 1.103–2.061; p = 0.01] and at 6 months (HR = 4.148; 95% CI, 2.523–6.820; p < 0.001) and 12 months (HR = 5.272; 95% CI, 3.630–7.656; p < 0.001) after operation was an independent prognostic factor of patients who underwent PD for ampullary carcinoma.ConclusionsSevere malnutrition before and at 6 and 12 months after operation significantly affects the long-term survival of patients with ampullary carcinoma who underwent PD. Additionally, the preoperative malnutrition was closely related to postoperative complications.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ryo Arikawa ◽  
Daisuke Kanda ◽  
Yoshiyuki Ikeda ◽  
Akihiro Tokushige ◽  
Takeshi Sonoda ◽  
...  

Abstract Background Stable coronary artery disease (CAD) patients with myocardial damage have a poor prognosis compared to those without myocardial damage. Recently, malnutrition has been reported to affect the prognosis of cardiovascular diseases. However, the effects of malnutrition on prognosis of CAD patients with myocardial damage remains uncertain. We investigated the effects of malnutrition on prognosis of CAD patients with myocardial damage who received percutaneous coronary intervention (PCI). Methods Subjects comprised 241 stable CAD patients with myocardial damage due to myocardial ischemia or infraction. Patients underwent successful revascularization for the culprit lesion by PCI using second-generation drug-eluting stents and intravascular ultrasound. The geriatric nutritional risk index (GNRI), which is widely used as a simple method for screening nutritional status using body mass index and serum albumin, was used to assess nutritional status. Associations between major cardiovascular and cerebrovascular events (MACCE) and patient characteristics were assessed. Results Mean GNRI was 100 ± 13, and there were 55 malnourished patients (23%; GNRI < 92) and 186 non-malnourished patients (77%). MACCE occurred within 3 years after PCI in 42 cases (17%), including 34 deaths (14%), and the malnourished group showed a higher rate of MACCE (38%) compared with the non-malnourished group (11%, p < 0.001). Univariate Cox proportional hazards analyses showed that MACCE was associated with age [hazard ratio (HR), 1.04; 95% confidence interval (CI), 1.04–1.07; p = 0.004], prior heart failure (HR 2.35; 95% CI 1.10–5.01; p = 0.027), high-sensitivity C-reactive protein (HR 1.08; 95% CI 1.03–1.11; p < 0.001), hemodialysis (HR 2.63; 95% CI 1.51–4.58; p < 0.001) and malnutrition (HR 3.69; 95% CI 2.11–6.42; p < 0.001). Multivariate Cox proportional hazards analysis revealed hemodialysis (HR 2.17; 95% CI 1.19–3.93; p = 0.011) and malnutrition (HR 2.30; 95% CI 1.13–4.67; p = 0.020) as significantly associated with MACCE. Furthermore, Cox proportional hazards models using malnutrition and hemodialysis revealed that patients with malnutrition and hemodialysis were at greater risk of MACCE after PCI than patients with neither malnutrition nor hemodialysis (HR 6.91; 95% CI 3.29–14.54; p < 0.001). Conclusions In CAD patients with myocardial damage, malnutrition (GNRI < 92) represents an independent risk factor for MACCE. Assessment of nutritional status may help stratify the risk of cardiovascular events and encourage improvements in nutritional status.


Author(s):  
Renato Rissi ◽  
George Azevedo Lemos ◽  
Ivan Luiz de Souza Pires ◽  
Rafael Ludemann Camargo ◽  
Evanisi Teresa Palomari

Introduction: The immobilization induces an unbalanced bone metabolism, followed by rapid bone loss and consequent loss of the mechanical function of the bone. In general, the obesity and protein malnutrition conditions affect a large number of people worldwide, and both morbidities have specific characteristics that may cause deleterious effects on bone tissues of patients by different mechanisms. Objective: the present study aimed to verify experimentally if the joint immobilization protocol causes bone tissue atrophy in obese and undernourished animals. Method: 20 adult male mice (C57/BL6) were used, divided into four groups (N=5): Control Group (CG), Immobilized Control Group (ICG), Immobilized Obese Group (IOG) and Immobilized Malnourished Group (IMG). The histomorphometric analysis of the tibia quantified the number of osteocytes, cortical thickness and diameter of the medullary canal. Results: The study involving the tibia of the animals showed statistical differences in variables analysis. All immobilized groups showed lower amount of osteocytes in the evaluated tissue and increase in diameter of the spinal canal when compared to the CG. The cortical thickness was reduced in ICG and IMG groups when compared to the CG. Conclusion: The used joint immobilization protocol caused bone atrophy in the studied animals. The association between obesity, malnutrition and joint immobilization conditions cause increase in bone tissue atrophy.


2019 ◽  
Vol 6 (4) ◽  
pp. 1247
Author(s):  
Rahul Singh ◽  
Shashank Shekhar Tripathi ◽  
Ankur Tripathi ◽  
Himansha Pandey

Background: Wound healing depends upon a balance between general factors which include nutritional status of the patient and local factors. Assessment of wound healing in relation to nutritional status of the patients in common surgical conditions.Methods: 46 surgical patients admitted in S.R.N. Hospital, Motilal Nehru Medical College, Allahabad during the period from July 2017 to July 2018, were included. Clinical, anthropometric examination, assessment of wound healing and factors affecting wound healing was done.Results: The mean age of the males patients were 38 years and that of female 33 years. Out of 46 patients included in our study 71.74% were male and 28.26% were females, and among these 15.15% of male and 38.46% female were malnourished. Percentage of wound contraction was 11.38% among the healthy and 2.30% in malnourished group, while the percentage of infection was 14% and 13% among healthy males and female and 20% each for malnourished males and females. Loss of weight was 9.4% and 10.1% among healthy male and female and 6.54% and 7.5% for malnourished male and females. The percentage of wound disruption in our study was 9% among malnourished group.Conclusions: Wound infection and disruption collectively increased the mortality and morbidity significantly in patients of malnourished group. Socio economic status has indirect correlation with wound healing. Malnourishment has a definite effect on wound healing.


2018 ◽  
Vol 6 (1) ◽  
pp. 127-134 ◽  
Author(s):  
Triawanti Triawanti ◽  
Ari Yunanto ◽  
Didik Dwi Sanyoto ◽  
Hendra Wana Nuramin

Prevalence of malnutrition in Indonesia is still high although it has some potential source of nutrients. Seluang fish (Rasbora spp.) is a river fish consumed by the people of South Kalimantan, Indonesia. This study analyzed the improvement of nutritional status in the malnourished rats after treatment with Seluang Fish. The study used malnourished white rats (Rattus norvegicus) using a low protein and fat diet for 8 weeks. The rats were divided into three groups; malnourished group (M) without other dietary treatment, standard diet (P1) and seluang diet (P2) for a period of four weeks. The malnourished group was sacrificed first, and after four weeks treatment, other groups were sacrificed; blood and bones were taken for weight, protein levels, hemoglobin levels, bone length, bone calcium levels and IGF-1 levels. The results showed that the average of body weight for all the studied groups ranged between 190 to 220g. Seluang diet had the highest serum protein levels (4.388 mg/dL), hemoglobin (19.7 mg/dL) and IGF levels (388.7 ng/mL). Standard diet had the longest bone length (3.547 cm) and the highest Calcium levels of 1.68 mg/g. Based on these results, it was concluded that Seluang fish may have the potential to improve the nutritional status of malnourished rats.


Author(s):  
Renato Rissi ◽  
George Azevedo Lemos ◽  
Bernardo Neme Ide ◽  
Rafael Ludemann Camargo ◽  
Renato Chaves Souto Branco ◽  
...  

DOI: http://dx.doi.org/10.5007/1980-0037.2016v18n1p1 Although it is a widely used resource for the treatment of musculoskeletal injuries, immobilization causes deleterious effects in muscle tissue after a short period of time. This study aimed to evaluate the gastrocnemius and tibialis anterior muscles of obese and protein malnourished animals under joint immobilization condition. Overall, 28 adult male mice were used (C57 / BL6), being divided into four groups (N = 7): Control Group (CG), Immobilized Control Group (ICG), Immobilized Obese Group (IOG) and Immobilized Malnourished Group (IMG). The immobilization protocol was performed by the use of adhesive tape and plaster. The conditions and obesity and protein malnutrition have been developed through the ingestion of diets specific for each group of animals. The histomorphometric analysis of muscles evaluated area and the diameter of muscle fibers. All immobilized groups showed reduction in the area and diameter of muscle fibers when compared to GC. Comparisons among immobilized groups showed that the area and diameter of muscle fibers of IOG and IMG were lower than ICG. The immobilization protocol caused reduction in muscle trophism in animals, and obese and malnourished animals suffered high losses under condition of muscle atrophy. 


2012 ◽  
Vol 84 (3) ◽  
pp. 799-806 ◽  
Author(s):  
Débora M.G. Sant'Ana ◽  
Eduardo J.A. Araújo ◽  
Diego H. Ramos ◽  
Catchia Hermes-Uliana ◽  
Maria Raquel M. Natali

The effects of severe protein malnutrition (4%) on myenteric neurons of Wistar rat duodenum, in relation to a standard 22%-protein diet for rodents, were assessed in this study. Segments of the duodenum from 10 rats from each nutritional group were submitted to the elaboration of whole mounts - 5 stained with Giemsa to determine the total population of myenteric neurons and the others stained by a histochemical method to detect nervous cells through the NADPH-diaphorase enzyme activity for studying the subpopulation of nitrergic neurons. The area of 100 neurons per animal, totalizing 2,000 neurons, were randomly measured by using the Image Pro-Plus®software. Malnourished rats presented 34.38% lower body weight and 10.60% duodenum length reduction when compared to the control group. Quantitative analysis demonstrated no significant differences between control and malnourished group by using Giemsa; however, as the organ reduction was not followed by an increase inversely proportional to the density of neurons, the condition imposed suggests the loss of neurons from the total population. Nevertheless, through NADPH-d histochemistry, there was a neuronal density increase for the malnourished group. There was no significant difference between the groups for both techniques with respect to the morphometric analysis of the body cell.


1993 ◽  
Vol 71 (9) ◽  
pp. 650-656 ◽  
Author(s):  
D. J. Philpott ◽  
D. R. Kirk ◽  
J. D. Butzner

We examined the role of luminal versus systemic factors in promoting intestinal recovery during the refeeding of previously malnourished infant rabbits. Malnutrition was induced by litter expansion at 7 days of age. A 20-cm Thiry–Vella (T-V) loop was created in the intestine of each malnourished and dietary control animal at 21 days of age. Beginning on day 28, controls and one half of the malnourished group (malnourished–refed) were fed chow ad libitum, whereas the remainder of the malnourished group received half the amount of chow given to the malnourished–refed group. On day 35, proximal and distal segments from the intact intestine that remained in continuity as well as segments from the excluded T-V loops were examined. Malnutrition severely reduced mucosal mass and disaccharidase activities in the intact distal intestine. A brief period of refeeding led to a rapid recovery of these parameters. In contrast, the excluded T-V loop segments of the control, malnourished, and malnourished–refed groups all displayed decreased mucosal mass and impaired function to a degree similar to that observed in the intact distal segment from the malnourished group. These results indicate that luminal factors are essential for (i) the maintenance of normal intestinal structure and function in infant rabbits and (ii) the promotion of mucosal repair following nutritional rehabilitation of malnourished animals.Key words: protein-energy malnutrition, intestinal adaptation, Thiry–Vella loop, refeeding.


1987 ◽  
Vol 58 (2) ◽  
pp. 215-220
Author(s):  
Takashi Miwa ◽  
Hiromu Shoji ◽  
Moshe Solomonow ◽  
Malektaj Yazdani ◽  
Tetsuo Nakamoto

1. Various biochemical variables of the skins of rat dams and their fetuses in which protein-energy malnutrition was induced during pregnancy were analysed.2. One group of dams was fed on a 200 g protein/kg diet as a control and the other was fed on a 60 g protein/kg diet as an experimental group. Each group of dams was fed from day 13 of gestation until day 22.3. Water, protein and hexosamine concentrations of the fetal skins in the malnourished group were greater than those in the control group, whereas in the dams′ skins, protein concentration was greater in the malnourished group than in the control group.4. Extractability of collagen with neutral salt and pepsin showed no difference between the groups in the skins of fetuses and dams. The content of type III collagen in the fetal skin did not differ between the groups, but was increased in the malnourished dams′ skins compared with that of the control group.5. The present study showed that protein-energy malnutrition during pregnancy significantly affects the metabolism of the skin in both fetuses and their dams. Furthermore, the skins of fetuses and dams are structurally altered in different ways by this nutritional stress.


PEDIATRICS ◽  
1983 ◽  
Vol 72 (2) ◽  
pp. 239-243 ◽  
Author(s):  
Sally Grantham-McGregor ◽  
William Schofield ◽  
Linda Harris

The effect of adding psychosocial stimulation to the treatment of severely malnourished children was studied. The study period covered children from the time they left the hospital to 24 months later. The children's developmental levels (DQs) were compared with those of two other groups who were in the hospital—an adequately nourished group with diseases other than malnutrition, and a severely malnourished group who received standard hospital care only. The children receiving intervention had structured play sessions in the hospital and were visited weekly for 2 years after returning home. During the visits paraprofessionals showed mothers how to continue structured play with their children. The malnourished children who did not receive intervention showed a marked deficit in developmental level compared with that of control children throughout the study. The control children showed a decline in developmental level with age, which is characteristic of disadvantaged children. The children receiving intervention showed marked improvements and by 24 months were ahead of the children who did not receive intervention in every subscale and were ahead of the adequately nourished children in two subscales. Both groups of malnourished children remained behind the control children in nutritional status and locomotor development.


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