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Severe acute malnutrition

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https://www.readbyqxmd.com/read/28424189/diagnostic-criteria-for-severe-acute-malnutrition-among-infants-aged-under-6-mo
#1
Martha Mwangome, Moses Ngari, Greg Fegan, Neema Mturi, Mohammed Shebe, Evasius Bauni, James A Berkley
Background: There is an increasing recognition of malnutrition among infants under 6 mo of age (U6M). Current diagnosis criteria use weight-for-length z scores (WLZs), but the 2006 WHO standards exclude infants shorter than 45 cm. In older children, midupper arm circumference (MUAC) predicts mortality better than does WLZ. Outcomes may also be influenced by exposure to HIV and size or gestational age at birth. Diagnostic thresholds for WLZ, MUAC, and other indexes have not been fully evaluated against mortality risk among U6M infants...
April 19, 2017: American Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28404577/outpatient-treatment-of-severe-acute-malnutrition-response-to-treatment-with-a-reduced-schedule-of-therapeutic-food-distribution
#2
Sheila Isanaka, Stephen R Kodish, Fatou Berthé, Ian Alley, Fabienne Nackers, Kerstin E Hanson, Rebecca F Grais
Background: Community-based management of severe acute malnutrition (SAM) has been shown to be safe and cost-effective, but program coverage remains low. Treatment models that maintain high levels of clinical effectiveness but allow for increased coverage are still needed. A reduced schedule of follow-up, in which children receive clinical follow-up and therapeutic foods on a monthly rather than weekly basis, may be one alternative.Objective: We aimed to describe the safety and feasibility of a monthly distribution of ready-to-use therapeutic food (RUTF) in the treatment of uncomplicated SAM, in terms of clinical response to treatment and household RUTF use...
April 12, 2017: American Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28401645/body-composition-and-micronutrient-deficiencies-in-patients-with-an-acute-exacerbation-of-chronic-obstructive-pulmonary-disease
#3
Charith Horadagoda, Timothy Dinihan, Mary Roberts, Kristina Kairaitis
Chronic obstructive pulmonary disease (COPD) is a multisystem disorder. Abnormal body composition (BC) and low serum micronutrient levels contribute significantly to morbidity associated with acute exacerbations of COPD (AECOPD). The BC and serum levels of selected micronutrients were recorded in prospective, consecutive patients admitted to hospital with an AECOPD in Western Sydney. 94 patients were enrolled, 43% female, the average age was 69.8 ± 8.2years(SD). Admission spirometry revealed a mean spirometric ratio of 0...
April 12, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28398257/the-life-course-implications-of-ready-to-use-therapeutic-food-for-children-in-low-income-countries
#4
Alessandra N Bazzano, Kaitlin S Potts, Lydia A Bazzano, John B Mason
The development of ready-to-use therapeutic food (RUTF) for the treatment of uncomplicated cases of severe acute malnutrition in young children from 6 months to 5 years old has greatly improved survival through the ability to treat large numbers of malnourished children in the community setting rather than at health facilities during emergencies. This success has led to a surge in demand for RUTF in low income countries that are frequently food insecure due to environmental factors such as cyclical drought...
April 11, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28381429/long-term-effects-of-severe-acute-malnutrition-on-lung-function-in-malawian-children-a-cohort-study
#5
Natasha Lelijveld, Marko Kerac, Andrew Seal, Emmanuel Chimwezi, Jonathan C Wells, Robert S Heyderman, Moffat J Nyirenda, Janet Stocks, Jane Kirkby
Early nutritional insults may increase risk of adult lung disease. We aimed to quantify the impact of severe acute malnutrition (SAM) on spirometric outcomes 7 years post-treatment and explore predictors of impaired lung function.Spirometry and pulse oximetry were assessed in 237 Malawian children (median age: 9.3 years) who had been treated for SAM and compared with sibling and age/sex-matched community controls. Spirometry results were expressed as z-scores based on Global Lung Function Initiative reference data for the African-American population...
April 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28380279/causes-and-consequences-of-the-leishmania-infantum-burden-in-patients-with-kala-azar-ndash-a-study-of-625-patients
#6
Danielle A Zacarias, Nuno Rolão, Flaviane A de Pinho, Ingridi Sene, Jailthon C Silva, Teresinha C Pereira, Dorcas L Costa, Carlos H N Costa
BACKGROUND: An infected host's Leishmania infantum load in blood is considered to be an estimate of his or her total parasite burden. Therefore, the measurement of blood parasite burden is important in the identification of factors involved in parasite control. METHODS: Quantitative polymerase chain reaction was performed on blood samples from 625 patients with kala-azar consecutively admitted to a reference hospital in Teresina, Brazil. Primers were used to amplify a segment of kDNA using the TaqMan system...
April 5, 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/28380179/liver-failure-following-biliopancreatic-diversions-a-narrative-review
#7
Everton Cazzo, José Carlos Pareja, Elinton Adami Chaim
CONTEXT AND OBJECTIVE: Occurrences of liver failure following jejunoileal bypass were extensively reported in the past and were one of the main factors that led to abandonment of this procedure. The newer predominantly malabsorptive procedures called biliopancreatic diversions (BPDs) have also been implicated in several cases of acute and subacute liver failure. The aim here was to review the current available evidence on occurrences of liver failure following BPDs. DESIGN AND SETTING: Narrative review; bariatric surgery service of a public university hospital...
January 2017: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28378463/quality-of-care-for-treatment-of-uncomplicated-severe-acute-malnutrition-delivered-by-community-health-workers-in-a-rural-area-of-mali
#8
Jose Luis Alvarez Morán, Franck G B Alé, Eleanor Rogers, Saul Guerrero
An alternative Community-based Management of Acute Malnutrition model with community health workers (CHWs) delivering treatment for uncomplicated severe acute malnutrition (SAM) was piloted in Mali. The capacity of the CHWs to evaluate, classify, and treat cases of uncomplicated SAM, to provide nutritional counselling to caretakers of children receiving treatment for SAM, malaria, pneumonia or diarrhoea and to correctly refer cases of complicated SAM, was assessed. This was done using direct observation by trained enumerators of the management of SAM cases using checklists, re-diagnosing the cases admitted for treatment and reviewing admissions cards and registers...
April 5, 2017: Maternal & Child Nutrition
https://www.readbyqxmd.com/read/28361753/handgrip-strength-and-weight-predict-long-term-mortality-in-acute-kidney-injury-patients
#9
S P Xavier, C R Goes, M N B Bufarah, A L Balbi, D Ponce
INTRODUCTION: Surviving acute kidney (AKI) patients have a higher late mortality compared with those admitted without AKI. The negative impact of malnutrition on the early outcome of AKI patients has recently been confirmed by various studies. However, its impact after hospital discharge has not been studied. The objective of the study was to determine the role of anthropometric measurements and handgrip strength as predictors of mortality 180 days after discharge. METHODOLOGY: Eighty-two survivors AKI patients who were older than 18 y old and followed by AKI team were prospectively evaluated...
February 2017: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28356427/microbiota-gut-brain-axis-modulator-of-host-metabolism-and-appetite
#10
REVIEW
Marcel van de Wouw, Harriët Schellekens, Timothy G Dinan, John F Cryan
The gut harbors an enormous diversity of microbes that are essential for the maintenance of homeostasis in health and disease. A growing body of evidence supports the role of this microbiota in influencing host appetite and food intake. Individual species within the gut microbiota are under selective pressure arising from nutrients available and other bacterial species present. Each bacterial species within the gut aims to increase its own fitness, habitat, and survival via specific fermentation of dietary nutrients and secretion of metabolites, many of which can influence host appetite and eating behavior by directly affecting nutrient sensing and appetite and satiety-regulating systems...
March 29, 2017: Journal of Nutrition
https://www.readbyqxmd.com/read/28347373/using-stable-isotope-techniques-in-nutrition-assessments-and-tracking-of-global-targets-post-2015
#11
Victor O Owino, Christine Slater, Cornelia U Loechl
Stable isotopes are non-radioactive, safe and are applied for various purposes in human health assessment in trace amounts that minimally disturb normal physiology. The International Atomic Energy Agency supports the use of stable isotope techniques to design and evaluate interventions addressing malnutrition in all its forms with focus on infant and young child feeding; maternal and adolescent nutrition; diet quality; prevention and control of non-communicable diseases; healthy ageing and gut function. These techniques can be used to objectively measure: (1) amount of human milk consumed and whether an infant is exclusively breastfed; (2) body composition in the context of re-feeding programmes for moderate and severe acute malnutrition and as an indicator of the risk for obesity; (3) bioavailability and bioconversion of pro-vitamin A and vitamin A body stores following vitamin A intervention programmes; (4) absorption and retention of iron, zinc and protein; (5) total energy expenditure for validation of physical activity measurement and dietary assessment tools and (6) diagnosis of Helicobacter pylori...
March 28, 2017: Proceedings of the Nutrition Society
https://www.readbyqxmd.com/read/28343801/impact-of-therapeutic-food-compared-to-oral-nutritional-supplements-on-nutritional-outcomes-in-mildly-underweight-healthy-children-in-a-low-medium-income-society
#12
Sadia Fatima, Dalia Malkova, Charlotte Wright, Konstantinos Gerasimidis
BACKGROUND & AIMS: Therapeutic foods (RUTF) are used to treat severe acute malnutrition in children 5 years and under in low and middle income countries (LMI), while liquid nutritional supplements (ONS) are used in affluent societies. With globalisation and economic growth in LMI, there will be an inclination to move towards practices applied in affluent countries. This study compared the effect of supplementation with a RUTF and an ONS, on nutritional outcomes in mildly underweight children...
March 16, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28337084/therapeutic-drug-monitoring-of-continuous-infusion-doripenem-in-a-pediatric-patient-on-continuous-renal-replacement-therapy
#13
Jeffrey J Cies, Wayne S Moore, Susan B Conley, Paul Shea, Adela Enache, Arun Chopra
An 11-year-old African American male with severe combined immunodeficiency variant, non-cystic fibrosis bronchiectasis, pancreatic insufficiency, chronic mycobacterium avium-intracellulare infection, chronic sinusitis, and malnutrition presented with a 1-week history of fevers. He subsequently developed respiratory decompensation and cefepime was discontinued and doripenem was initiated. Doripenem was the carbapenem used due to a national shortage of meropenem. By day 7 the patient (24.7 kg) had a positive fluid balance of 6925 mL (28% FO), and on days 7 into 8 developed acute kidney injury evidenced by an elevated serum creatinine of 0...
January 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28331940/acute-thymic-involution-and-mechanisms-for-recovery
#14
REVIEW
Abdur Rahman Ansari, Huazhen Liu
Acute thymic involution (ATI) is usually regarded as a virulence trait. It is caused by several infectious agents (bacteria, viruses, parasites, fungi) and other factors, including stress, pregnancy, malnutrition and chemotherapy. However, the complex mechanisms that operate during ATI differ substantially from each other depending on the causative agent. For instance, a transient reduction in the size and weight of the thymus and depletion of populations of T cell subsets are hallmarks of ATI in many cases, whereas severe disruption of the anatomical structure of the organ is also associated with some factors, including fungal, parasitic and viral infections...
March 22, 2017: Archivum Immunologiae et Therapiae Experimentalis
https://www.readbyqxmd.com/read/28330812/molecular-evidence-for-differential-long-term-outcomes-of-early-life-severe-acute-malnutrition
#15
Allan Sheppard, Sherry Ngo, Xiaoling Li, Michael Boyne, Debbie Thompson, Anthony Pleasants, Peter Gluckman, Terrence Forrester
BACKGROUND: Severe acute malnutrition (SAM) in infants may present as one of two distinct syndromic forms: non-edematous (marasmus), with severe wasting and no nutritional edema; or edematous (kwashiorkor) with moderately severe wasting. These differences may be related to developmental changes prior to the exposure to SAM and phenotypic changes appear to persist into adulthood with differences between the two groups. We examined whether the different response to SAM and subsequent trajectories may be explained by developmentally-induced epigenetic differences...
March 8, 2017: EBioMedicine
https://www.readbyqxmd.com/read/28323233/iloprost-use-in-patients-with-persistent-intestinal-ischemia-unsuitable-for-revascularization
#16
Alexandre Nuzzo, Damien Soudan, Lore Billiauws, Julie Bataille, Léon Maggiori, Maxime Ronot, Jeanick Stocco, Yoram Bouhnik, Yves Castier, Olivier Corcos
INTRODUCTION: Persistent or chronic intestinal ischemic injury (i3) can lead to severe malnutrition and acute mesenteric ischemia. Although recommended, revascularization of splanchnic arteries is sometimes unrealizable. MATERIAL AND METHODS: We report a case series of iloprost use in consecutive stable patients with persistent i3 unsuitable for revascularization followed in a tertiary care center. The feasibility of revascularization was discussed and ruled out by a multidisciplinary team, and informed consent was obtained prior to consideration of a vasoactive therapy...
March 16, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28317139/mortality-after-inpatient-treatment-for-severe-pneumonia-in-children-a-cohort-study
#17
Moses M Ngari, Greg Fegan, Martha K Mwangome, Mwanajuma J Ngama, Neema Mturi, John Anthony Gerard Scott, Evasius Bauni, David James Nokes, James A Berkley
BACKGROUND: Although pneumonia is a leading cause of inpatient mortality, deaths may also occur after discharge from hospital. However, prior studies have been small, in selected groups or did not fully evaluate risk factors, particularly malnutrition and HIV. We determined 1-year post-discharge mortality and risk factors among children diagnosed with severe pneumonia. METHODS: A cohort study of children aged 1-59 months admitted to Kilifi County Hospital with severe pneumonia (2007-12)...
March 20, 2017: Paediatric and Perinatal Epidemiology
https://www.readbyqxmd.com/read/28291805/socioeconomic-factors-associated-with-severe-acute-malnutrition-in-jamaica
#18
Debbie S Thompson, Novie Younger-Coleman, Parris Lyew-Ayee, Lisa-Gaye Greene, Michael S Boyne, Terrence E Forrester
OBJECTIVES: Severe acute malnutrition (SAM) is an important risk factor for illness and death globally, contributing to more than half of deaths in children worldwide. We hypothesized that SAM is positively correlated to poverty, low educational attainment, major crime and higher mean soil concentrations of lead, cadmium and arsenic. METHODS: We reviewed admission records of infants admitted with a diagnosis of SAM over 14 years (2000-2013) in Jamaica. Poverty index, educational attainment, major crime and environmental heavy metal exposure were represented in a Geographic Information System (GIS)...
2017: PloS One
https://www.readbyqxmd.com/read/28288591/correlates-of-thymus-size-and-changes-during-treatment-of-children-with-severe-acute-malnutrition-a-cohort-study
#19
Maren Johanne Heilskov Rytter, Hanifa Namusoke, Christian Ritz, Kim F Michaelsen, André Briend, Henrik Friis, Dorthe Jeppesen
BACKGROUND: The impairment of immune functions associated with malnutrition may be one reason for the high mortality in children with severe acute malnutrition (SAM), and thymus atrophy has been proposed as a marker of this immunodeficiency. The aim of this study was to identify nutritional and clinical correlates of thymus size in children with SAM, and predictors of change in thymus size with nutritional rehabilitation. METHODS: In an observational study among children aged 6-59 months admitted with SAM in Uganda, we measured thymus area by ultrasound on hospital admission to treatment with F75 and F100, on hospital discharge and after 8 weeks of nutritional rehabilitation with ready-to-use therapeutic food, as well as in well-nourished healthy children...
March 14, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28287482/comparison-of-mid-upper-arm-circumference-and-weight-for-height-to-diagnose-severe-acute-malnutrition-a-study-in-southern-ethiopia
#20
Amare Worku Tadesse, Elazar Tadesse, Yemane Berhane, Eva-Charlotte Ekström
Weight-for-height Z-score (WHZ) and mid-upper arm circumference (MUAC) are two independent anthropometric indicators for diagnosing and admitting children with severe acute malnutrition (SAM) for treatment. While severely wasted children are at high risk of mortality, MUAC and WHZ do not always identify the same population of children as having SAM. Understanding how this discrepancy relates to age and sex may provide valuable information for care programmes for children with SAM. Age and sex distribution for differences between children identified as SAM by MUAC and WHZ were examined and the degree of agreement calculated...
March 11, 2017: Nutrients
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