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Severe acute malnutrition

Ekta Agarwal, Maree Ferguson, Merrilyn Banks, Angela Vivanti, Marijka Batterham, Judy Bauer, Sandra Capra, Elisabeth Isenring
BACKGROUND & AIMS: Obesity, defined as a BMI ≥ 30 kg/m2 , has demonstrated protective associations with mortality in some diseases. However, recent evidence demonstrates that poor nutritional status in critically ill obese patients confounds this relationship. The purpose of this paper is to evaluate if poor nutritional status, poor food intake and adverse health-related outcomes have a demonstrated association in non-critically ill obese acute care hospital patients. METHODS: This is a secondary analysis of the Australasian Nutrition Care Day Survey dataset (N = 3122), a prospective cohort study conducted in hospitals from Australia and New Zealand in 2010...
March 10, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Hayley K Hutton, Heather J Zar, Andrew C Argent
Aim: Severe acute lower respiratory tract infection (ALRTI) remains an important cause of childhood morbidity and mortality. Methods: This is a 12-month retrospective cohort study of children (0-12 years) admitted to a pediatric intensive care unit (PICU) with ALRTI to investigate risk factors, clinical course and in-hospital survival. Results: In total, 265 patients (median age = 4 months [2-12 months]) were identified. In all,102 (38...
March 9, 2018: Journal of Tropical Pediatrics
Joe D Piper, Salim Mwarumba, Moses Ngari, Benedict Mvera, Susan Morpeth, James A Berkley
For children with acute malnutrition, ready-to-use therapeutic foods (RUTF) are lifesaving treatments. In 2012, detailed testing detected Enterobacteriaceae including Cronobacter species at low levels in RUTF from all UNICEF-approved producers. Cronobacter in milk feeds has previously been associated with severe neonatal infections. Thus, given the susceptibility of severely malnourished children to invasive bacterial infections, concerns arose about the potential for Cronobacter infections from RUTF. This led to widespread production and supply problems in emergency feeding programmes...
March 13, 2018: Paediatrics and International Child Health
Charu C Garg, Sarmila Mazumder, Sunita Taneja, Medha Shekhar, Sanjana Brahmawar Mohan, Anuradha Bose, Sharad D Iyengar, Rajiv Bahl, Jose Martines, Nita Bhandari
Trial design: Three feeding regimens-centrally produced ready-to-use therapeutic food, locally produced ready-to-use therapeutic food, and augmented, energy-dense, home-prepared food-were provided in a community setting for children with severe acute malnutrition (SAM) in the age group of 6-59 months in an individually randomised multicentre trial that enrolled 906 children. Foods, counselling, feeding support and treatment for mild illnesses were provided until recovery or 16 weeks. Methods: Costs were estimated for 371 children enrolled in Delhi in a semiurban location after active survey and identification, enrolment, diagnosis and treatment for mild illnesses, and finally treatment with one of the three regimens, both under the research and government setting...
2018: BMJ Global Health
Catherine E Oldenburg, Philippe J Guerin, Fatou Berthé, Rebecca F Grais, Sheila Isanaka
Background: The relationship between malaria infection and nutritional status is complex and previous studies suggest malaria may increase the incidence and severity of malnutrition while malnutrition may increase the risk of malaria infection. Here, we report bi-directional associations between malaria and nutritional status among children with uncomplicated severe acute malnutrition (SAM). Methods: The present study is a secondary analysis of a randomized controlled trial for the treatment of uncomplicated SAM in Niger...
March 7, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Ji Li, Chang Wang, Xiaoliang Liu, Qiuju Liu, Hai Lin, Chunshui Liu, Fengyan Jin, Yan Yang, Ou Bai, Yehui Tan, Sujun Gao, Wei Li
To evaluate nutritional status in adult patients with acute leukemia (AL) using patient-generated subjective global assessment (PG-SGA) and to investigate the influence of nutritional status on prognosis.We observationally investigated 68 adult patients with newly diagnosed AL who received PG-SGA at the First Hospital of Jilin University between May 2013 and July 2015. Clinical features, chemotherapy regimens, biochemical indexes, body composition, complete remission (CR) rate, minimal residual disease (MRD), survival time, and side-effects of chemotherapy were compared between patients with and without severe malnutrition...
January 2018: Medicine (Baltimore)
Deepak Dwivedi, Surendra Singh, Jyoti Singh, Naresh Bajaj, Harendra Pratap Singh
OBJECTIVE: This cross sectional study was done to assess the developmental status in children (6-30 mo old) with severe acute malutrition (SAM). METHODS: Study subjects were enrolled from children in SAM therapeutic unit, and controls were selected from well-baby clinic of the institute. Neurodevelopment of both groups was assessed using the Developmental assessment scale of Indian infants (DASII). Developmental quotient (DQ) ≤70 was considered delayed. RESULTS: Mean (SE) motor DQ 59...
February 15, 2018: Indian Pediatrics
Marta Farràs, Kanta Chandwe, Jordi Mayneris-Perxachs, Beatrice Amadi, John Louis-Auguste, Ellen Besa, Kanekwa Zyambo, Richard Guerrant, Paul Kelly, Jonathan Richard Swann
BACKGROUND: Environmental enteric dysfunction (EED) is widespread throughout the tropics and in children is associated with stunting and other adverse health outcomes. One of the hallmarks of EED is villus damage. In children with severe acute malnutrition (SAM) the severity of enteropathy is greater and short term mortality is high, but the metabolic consequences of enteropathy are unknown. Here, we characterize the urinary metabolic alterations associated with villus health, classic enteropathy biomarkers and anthropometric measurements in severely malnourished children in Zambia...
2018: PloS One
Takatoshi Anno, Hideaki Kaneto, Ryo Shigemoto, Fumiko Kawasaki, Yasuhiro Kawai, Noriyo Urata, Hirofumi Kawamoto, Kohei Kaku, Niro Okimoto
Hypoglycemia is induced by many causes, especially over-dose of insulin or oral hypoglycemic agents in diabetic subjects. In such a case, hyperinsulinemic hypoglycemia is usually observed. On the other hand, it is important to classify secondary hypoglycemia and hypoinsulinemic hypoglycemia. Liver injury-induced hypoglycemia is one of the causes of hypoinsulinemic hypoglycemia but rarely observed in clinical practice. Herein, we experienced similar 2 cases of non-diabetic hypoinsulinemic hypoglycemia. Both of them were elderly subjects with low body weight...
2018: Endocrinology, Diabetes & Metabolism Case Reports
Misbah Anjum, Khemchand N Moorani, Bilquis Naeem, Shazia Kulsoom, Ashfaq Ahmed Memon
Objectives: First objective was to compare eGFR by Updated Schwartz (US) and Simple Height Independent (SHID) formula with Original Schwartz (OS) in children with Severe Acute Malnutrition (SAM). The second objective was to compare eGFR in children below and above two years. Methods: This analytic study on estimation of GFR was based on retrospective data collected from 78 children with SAM at Nutritional Rehabilitation Unit from October 2014 - March 2015. Glomerular filtration rate was calculated using serum creatinine (S...
November 2017: Pakistan Journal of Medical Sciences Quarterly
Mathias Altmann, Chiara Altare, Nanette van der Spek, Jean-Christophe Barbiche, Jovana Dodos, Mahamat Bechir, Myriam Ait Aissa, Patrick Kolsteren
Water, sanitation and hygiene (WASH) interventions have a small but measurable benefit on stunting, but not on wasting. Our objective was to assess the effectiveness of a household WASH package on the performance of an Outpatient Therapeutic feeding Program (OTP) for severe acute malnutrition (SAM). We conducted a cluster-randomized controlled trial embedded in a routine OTP. The study population included 20 health centers (clusters) from Mao and Mondo districts in Chad. Both arms received the OTP. The intervention arm received an additional household WASH package (chlorine, soap, water storage container, and promotion on its use)...
February 26, 2018: American Journal of Tropical Medicine and Hygiene
Angeline Grant, James Njiru, Edgar Okoth, Imelda Awino, André Briend, Samuel Murage, Saida Abdirahman, Mark Myatt
Background: A novel approach for improving community case-detection of acute malnutrition involves mothers/caregivers screening their children for acute malnutrition using a mid-upper arm circumference (MUAC) insertion tape. The objective of this study was to test three simple MUAC classification devices to determine whether they improved the sensitivity of mothers/caregivers at detecting acute malnutrition. Methods: Prospective, non-randomised, partially-blinded, clinical diagnostic trial describing and comparing the performance of three "Click-MUAC" devices and a MUAC insertion tape...
2018: Archives of Public Health, Archives Belges de Santé Publique
Dong-Yi Hsieh, Jen-Wen Hung, Ku-Chou Chang, Yu-Ching Huang, Tsong-Hai Lee, Hsiu-Min Chen
BACKGROUND: Stroke results in high mortality with tremendous health care burden. Malnutrition is frequently observed in patients after stroke. This study was designed to explore the nutritional status in the acute stage of stroke aiming at exploring factors related to malnutrition after stroke. METHODS: This was a hospital based, prospective, observational study recruiting cerebrovascular diseases patients hospitalized for acute management. Patients suffered from all kinds of cerebrovascular diseases hospitalized for management within 30 days after onset were consecutively recruited in the study hospitals...
September 15, 2017: Acta Neurologica Taiwanica
Etienne Nel
PURPOSE OF REVIEW: Advances in our understanding of the treatment of severe acute malnutrition (SAM) in a resource-limited environment are needed to improve outcome. RECENT FINDINGS: Ready-to-use therapeutic foods (RUTFs) made from local products and with reduced milk content lower costs and may be effective in older children. None of the therapeutic foods used to treat severely malnourished children correct long chain polyunsaturated fatty acid deficiencies.Routine short-term antibiotic (amoxicillin) treatment, in the context of adequate healthcare supervision, does not improve the recovery rate...
February 15, 2018: Current Opinion in Clinical Nutrition and Metabolic Care
D K Daphnee, Sheila John, P Rajalakshmi, Anil Vaidya, Anand Khakhar, S Bhuvaneshwari, Anand Ramamurthy
BACKGROUND AND AIM: Nutritional therapy is an integral part of care in all phases of liver transplantation (LTx). However, there are several factors that make it a challenge to manage malnutrition in these patients including, but not limited to, loss of appetite, dietary restrictions and dietary habits. Dietary habits are guided by personal choice, social, cultural and regional background with diversity ranging from veganism to vegetarianism with the latter predominant in Indian population...
February 2018: Clinical Nutrition ESPEN
Eleanor Rogers, Karen Martínez, Jose Luis Alvarez Morán, Franck G B Alé, Pilar Charle, Saul Guerrero, Chloe Puett
BACKGROUND: The Malian Nutrition Division of the Ministry of Health and Action Against Hunger tested the feasibility of integrating treatment of severe acute malnutrition (SAM) into the existing Integrated Community Case Management package delivered by community health workers (CHWs). This study assessed costs and cost-effectiveness of CHW-delivered care compared to outpatient facility-based care. METHODS: Activity-based costing methods were used, and a societal perspective employed to include all relevant costs incurred by institutions, beneficiaries and communities...
February 20, 2018: Human Resources for Health
Tatsuro Inoue, Shogo Misu, Toshiaki Tanaka, Tetsuya Kakehi, Rei Ono
BACKGROUND & AIMS: Several hip fracture patients are malnourished, but no study has attempted to determine the optimal nutritional screening tool for predicting functional outcomes. We investigated the association between each nutritional status assessed by four nutritional screening tools at admission and functional outcomes during the postoperative acute phase in hip fracture patients. METHODS: The Mini Nutritional Assessment-Short Form (MNA-SF), the Malnutrition Universal Screening Tool (MUST), the Nutritional Risk Score 2002 (NRS-2002) and the Geriatric Nutritional Risk Index (GNRI) were assessed at admission before surgery...
February 15, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Andrea L Conroy, Michael T Hawkes, Robyn Elphinstone, Robert O Opoka, Sophie Namasopo, Christopher Miller, Chandy C John, Kevin C Kain
BACKGROUND: Chitinase-3-like 1 (CHI3L1) is a glycoprotein elevated in paediatric severe malaria, and an emerging urinary biomarker of acute kidney injury (AKI). Based on the hypothesis that elevated CHI3L1 levels in malaria are associated with disease severity, the relationship between plasma CHI3L1 levels, AKI and mortality was investigated in Ugandan children enrolled in a clinical trial evaluating inhaled nitric oxide (iNO) as an adjunctive therapy for severe malaria. METHODS: Plasma CHI3L1 levels were measured daily for 4 days in children admitted to hospital with severe malaria and at day 14 follow up...
February 15, 2018: Malaria Journal
Samuel Girma, Mekonnen Sisay, Getnet Mengistu, Firehiwot Amare, Dumessa Edessa
Background: Antimicrobials are among the most frequently prescribed medications for pediatric patients. However, inappropriate use of them can increase morbidity, mortality, healthcare costs, and largely antimicrobial resistance. This study aims to assess the antimicrobial utilization pattern in the pediatric ward of Hiwot Fana Specialized University Hospital. Methods: Retrospective cross-sectional study was conducted to assess the antimicrobial utilization. In this study, 403 pediatric medical records selected by systematic random sampling were reviewed...
February 2018: Hospital Pharmacy
Mulugeta Yohannis Kabalo, Bereket Yohannes
OBJECTIVES: Severely undernourished young children clinically present with a typical nutritional oedema or none-oedematous. However, research evidence is limited on how these types predict treatment outcomes in Ethiopia. This study was aimed to compare oedematous and none-oedematous children for their treatment outcomes in Boloso Sore district in Southwest Ethiopia. RESULTS: The overall recovery rate was 396 (68%). From oedematous children; 235 (79.9%) recovered, 18 (6...
February 9, 2018: BMC Research Notes
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