Background: Malnutrition, a serious public health concern, is influenced by various factors. Objective: The study aims to explore malnutrition issues among infants under five years old in Guéra Province. Methods:...Background: Malnutrition, a serious public health concern, is influenced by various factors. Objective: The study aims to explore malnutrition issues among infants under five years old in Guéra Province. Methods: The study used a cross-sectional design and a two-stage cluster sampling method to select participants. The study population was infants aged between 0 - 24 months. Data collection was done between June 2023 and September 2024;it included anthropometric measurements, blood analyses, and interviews. Anthropometric parameters were calculated using ENA for SMART software. Statistical analyses were performed by R Studio to investigate associations between different characteristics, using logistic regression models to identify risk factors. A p-value less than 0.05 was considered significant. Results: The study included 377 infants in eight villages in Guéra Province, Chad. The sample was predominantly girls (55.3%), with a median age of 16 months. Most infants (94%) were mixed-fed, and only 6% were exclusively breastfed. We found that 7.3% of children were globally malnourished, with higher rates in boys 9.6%. A significant disparity existed between boys and girls in global acute malnutrition (GAM) rates, with boys having a higher prevalence of 17.9%. A substantial proportion of Infants were underweight, with males 27.4%. Stunting was prevalent 20.1%. Several factors were associated with malnutrition, including gender, feeding practices, infectious diseases, and socioeconomic factors. Diarrhea, malaria, limited access to drinking water, and early diet diversification were significantly associated with malnutrition. Conclusion: Targeted interventions are necessary to address these issues and improve the nutritional status of children in the Guéra province.展开更多
Background: Severe acute malnutrition (SAM) is one of the major public health problems associated with increased mortality in under-five children. In low-income countries, renal dysfunction (RD) contributes to about 3...Background: Severe acute malnutrition (SAM) is one of the major public health problems associated with increased mortality in under-five children. In low-income countries, renal dysfunction (RD) contributes to about 34% mortality in under-five children with severe acute malnutrition. This study aimed to determine the impacts of severe acute malnutrition on the kidney among the admitted under-five children. Methods: In this prospective longitudinal observational study, a total of 190 children aged 6 to 59 months were enrolled from Iringa and Dodoma tertiary hospitals. Socio-demographic, clinical and laboratory data were collected using a structured questionnaire. Estimated Glomerular Filtration Rate (eGFR) and urine albumin creatinine ratio (uACR) were used to determine RD. Data analysis was done using SPSS version 26 and statistical significance was assumed for factors with p-value Results: Out of 190 children with severe acute malnutrition, 36 (19%) had renal dysfunction. Factors associated with RD in malnourished children were the history of local herbs used within one week (AOR = 5.85, 95% CI [1.41, 24.319], p = 0.0152), Acute watery diarrhea with severe dehydration (AOR = 2.15, 95% CI [1.033, 4.711], p = 0.0166), and positive urine leukocytes (AOR = 19.91, 95% CI [4.09, 96.989], p = 0.0002). At three months of follow up, out of 36 children with RD, 20 (55.56%) attained full recovery, while 4 (11.11%) developed chronic kidney disease (CKD). Children with RD had prolonged hospital stays for more than 14 days with a mean 12.25 ± 5.00 days compared to those with no RD with a mean 6.29 ± 1.68 days (p Conclusion: Renal dysfunction is common among children with severe acute malnutrition. It is associated with prolonged hospital stays and increased mortality. Further studies which can determine the burden of RD in children with severe acute malnutrition as compared to those with no severe acute malnutrition are needed.展开更多
BACKGROUND Childhood malnutrition contributes over half of the childhood mortality around the world,predominantly in South-Asian and sub-Saharan countries.AIM To summarize the childhood malnutrition epidemiology along...BACKGROUND Childhood malnutrition contributes over half of the childhood mortality around the world,predominantly in South-Asian and sub-Saharan countries.AIM To summarize the childhood malnutrition epidemiology along with the comorbid factors associated with it and its management within the community.METHODS The data collection process involved conducting a comprehensive search using specific keywords such as child nutrition disorders and India with Boolean operators.The search was conducted in the Scopus and PubMed electronic databases.RESULTS Inadequate energy consumption initiates pathological alterations in the form of growth retardation,fat,visceral,and muscle loss,a reduction in basal metabolic rate,and a significant reduction in total energy expenditure.It has become evident that malnutrition shows an increased prevalence and incidence rate,despite available guidelines for the management of malnutrition.CONCLUSION Malnutrition can be a major player in the establishment of severe infections that result in significant post discharge mortalities in children.Future trials are required to fill the prime gaps in knowledge regarding the identification of other contributory factors in the pathogenesis of malnutrition and postdischarge infection.New biomarkers for early detection of malnutrition should be the priority of the scientific community for the early management of malnutrition.展开更多
Malnutrition is not only a prevalent condition among the elderly but also a common comorbidity in elderly people with gastric cancer(GC).Malnutrition is closely linked to high rates of postoperative complications and ...Malnutrition is not only a prevalent condition among the elderly but also a common comorbidity in elderly people with gastric cancer(GC).Malnutrition is closely linked to high rates of postoperative complications and poor wound healing in elderly GC patients,which may lead to a higher incidence and mor-tality rate of GC.Malnutrition decreases the physical function of elderly GC patients after surgery,severely affecting their postoperative life quality and hindering subsequent treatments.This retrospective study was conducted by Zhao et al,focusing on the clinical baseline data,postoperative complications,and hospitalization times of elderly GC patients who underwent curative gastrectomy.Additionally,the underlying causes of poor outcomes for patients were discussed.This study may provide a solid basis for the clinical treatment of elderly GC patients in the future.Therefore,malnutrition can serve as a negative prognostic factor for curative surgery in GC patients.Addressing malnutrition and its adverse effects can benefit elderly GC patients from surgical treatment.展开更多
Introduction: Malnutrition is a major public health problem in Mali, despite the efforts of the government, its technical and financial partners. The aim of this study was to evaluate the integrated management program...Introduction: Malnutrition is a major public health problem in Mali, despite the efforts of the government, its technical and financial partners. The aim of this study was to evaluate the integrated management program for acute malnutrition (IMPAM). Methodology: This was a descriptive cross-sectional study that took place from January to December 2020 in the Douentza health district. The study included anyone with at least one malnourished child aged 6 to 59 months in their care who agreed to take part in the study, community health center staff who had given their consent, and the URENI manager at the Douentza reference health center. Data collected via questionnaires were entered into Excel and then analyzed using Epi-Info version 7 software. Results: A total of 138 acutely malnourished children aged 6 - 59 months, including 71 girls (51.45%), 138 accompanying mothers and 11 health workers, were included in our case study. Among the malnourished, 54.34% were in the 12 - 23 months age group and 69.57% had the severe form. 93% of the mothers interviewed were satisfied with the care provided, and all the health staff interviewed stated that community conflicts had an impact on IMPAM’s activities. Cure rates were 81% in Moderate Outpatient Nutritional Recovery and Education Unit (URENAM), 84% in Severe Ambulatory Nutritional Recovery and Education Unit (URENAS) and 92% in Recovery and Intensive Nutritional Education Unit (URENI). Drop-out rates were 19% in URENAM, 16% in URENAS and 0% in URENI. The death rate was 8% in URENI and 0% in URENAM and URENAS. Conclusion: This study confirms the high prevalence of malnutrition in the district (10.54%). It also reveals that factors such as inter-community conflict and insecurity have seriously affected the IMPAM program.展开更多
Malnutrition refers to the deficiency, imbalances, or excesses in a person’s intake of energy or nutrients [1]. Khan defines anaemia as below level of Haemoglobin in red blood shown by a lower number of functioning r...Malnutrition refers to the deficiency, imbalances, or excesses in a person’s intake of energy or nutrients [1]. Khan defines anaemia as below level of Haemoglobin in red blood shown by a lower number of functioning red blood cells [2]. The crisis in the North West and South West Regions of Cameroon has led to several negative effects on children’s living conditions. There has been an increase in malnutrition and anaemia in the South West Region and Kumba in particular. The main objective of this study was “to examine the prevalence of malnutrition and anaemia in children ≤ 5 years of age in some conflict-hit areas of Meme Division”. A descriptive cross-sectional study was conducted in 2023 from March to June. We recruited 200 children ≤ 5 years into the study from three hospitals. The regional hospital annex in Kumba, Presbyterian General Hospital Kumba and the Ntam Hospital in Kumba. Socio-demographic factors were assessed using questionnaire, nutritional status was assessed by the use anthropometric measurements and an auto haematology analyser was used to determine anaemia. The overall prevalence of malnutrition in the study area was 40.5%. The prevalence of malnutrition varied significantly (P < 0.001) with the study sites. The overall prevalence of anaemia in the study area was 70.5%. The prevalence of anaemia was not significantly associated with the study sites. The prevalence of Malnutrition and Anaemia in children ≤ 5 years of age is very high in the Kumba municipalities. This could be attributed to the ongoing crisis which has caused a lot of social migrations from rural areas to Urban areas which are safer.展开更多
Introduction: Failure to thrive (FTT) occurs when a child’s growth falls below expected standards, typically due to inadequate nutrient intake. Factors include insufficient oral intake, poor nutrient absorption, and ...Introduction: Failure to thrive (FTT) occurs when a child’s growth falls below expected standards, typically due to inadequate nutrient intake. Factors include insufficient oral intake, poor nutrient absorption, and increased metabolic demands. Previous studies have shown high malnutrition rates in hospitalized children due to illness-related metabolic demands, decreased appetite, and inadequate intake. Our objective was to assess the growth and nutritional status of children admitted to King Abdullah University Hospital (KAUH) and identify the prevalence of undernutrition and associated factors. Methods: This prospective, cross-sectional cohort study was conducted at KAUH from July to December 2022. We included children aged 2 months to 16 years, excluding those with conditions altering growth parameters. Data were collected through pediatric data sheets, physical examinations, and laboratory tests. Anthropometric measurements were taken, and growth was assessed using CDC growth charts. Nutritional anemia was defined as hemoglobin 16. Results: A total of 111 patients were included (56.8% male, median age 65 months). Most patients had normal height (82%) and weight (86.5%) upon admission. However, 14.4% were stunted, 11.7% were underweight, 14.4% were overweight, and 3.6% were obese. Growth impairment correlated with higher anemia rates (p = 0.042). Nutritional anemia was present in 12% of patients. No significant relation was found between breastfeeding history and growth retardation, but maternal perception of malnutrition correlated well with actual malnutrition. Conclusion: Our study found a malnutrition prevalence of 19.8%, highlighting the need for systematic nutritional screening in hospitalized children. The study’s limitations include its small sample size and specific patient population, suggesting the need for larger, multicenter studies for more generalizable results.展开更多
Background: The incidence of femoral intertrochanteric fractures in older adults is higher than that of femoral neck fractures;however, both conditions are often analyzed together as proximal femoral fractures. Consid...Background: The incidence of femoral intertrochanteric fractures in older adults is higher than that of femoral neck fractures;however, both conditions are often analyzed together as proximal femoral fractures. Considering the difference in treatment, postoperative complication, and mortality risk, these two fractures should be analyzed separately. This study aimed to analyze 1-year mortality and its risk factors in patients with surgically treated femoral intertrochanteric fractures. Methods: Consecutive patients with intertrochanteric fractures who underwent surgical interventions at our institution between January 2017 and December 2021 were retrospectively reviewed. A total of 238 patients were eligible for inclusion in this study. Patients’ demographic and clinical information were retrospectively collected. Patients were divided into the 1-year mortality (n = 16) and survival (n = 222) groups. The incidence of 1-year mortality and its independent risk factors were investigated using univariate and multivariate logistic regression analyses. Results: The mean age of patients was 85.6 ± 8.5 years. The 1-year mortality rate was 6.7% (16/238). Preoperative albumin level, the Geriatric Nutritional Risk Index (GNRI), and malnutrition status (GNRI p = 0.02, p = 0.02, and p = 0.0011, respectively). Multivariate analysis showed that malnutrition status (GNRI p = 0.035) was an independent risk factor for 1-year mortality. Conclusion: Malnutrition status assessed using GNRI (GNRI < 92) was an independent risk factor for 1-year mortality. Our findings suggest that GNRI may be an effective screening tool for predicting postoperative 1-year mortality of patients with surgically treated femoral intertrochanteric fractures.展开更多
Introduction: Child malnutrition is a major public health problem in Côte d’Ivoire in sub-Saharan Africa. This study aimed to determine the prevalence and factors influencing malnutrition in children under five ...Introduction: Child malnutrition is a major public health problem in Côte d’Ivoire in sub-Saharan Africa. This study aimed to determine the prevalence and factors influencing malnutrition in children under five in the peri-urban area of Abidjan, the economic capital. Patients and Methods: We carried out a prospective cross-sectional analytical study from May 3rd to October 31st 2019 at the General Hospital of Yopougon Attié in a peri-urban district of Abidjan, the economic capital. The study included 522 children aged 0 to 59 months who were received for a consultation, with the informed consent of their parents. The assessment of nutritional status was based on WHO growth standards. Statistical comparisons were made using the Chi-2 test for a significant p-value below 5%. Results: The population was predominantly female (sex ratio of 0.91) with an average age of 8.21 months and overall modest socio-economic conditions. The prevalence of malnutrition was as follows: 3.45% of malnutrition by excess, including 0.57% of obesity, 16.09% of stunting (5.75% severe), 12.07% of underweight (3.45% severe), 8.04% emaciation (1.91% severe). Three risk factors were identified for default malnutrition: age less than 6 months (p = 0.022), low birth weight (p = 0.003), and prematurity (p Conclusion: Malnutrition by deficiency is common in peri-urban areas in Abidjan with the main risk factors being age less than 6 months, low birth weight and prematurity. Fighting against those risk factors could help improve the nutritional status of children under five in the peri-urban environment of Abidjan.展开更多
Introduction: Malnutrition is a pathological state resulting from the relative deficiency or excess of one or more essential nutrients, whether manifested clinically or detected only by biochemical, anthropometric or ...Introduction: Malnutrition is a pathological state resulting from the relative deficiency or excess of one or more essential nutrients, whether manifested clinically or detected only by biochemical, anthropometric or physiological analyses. The overall objective was to assess the quality of management of acute malnutrition in children aged 0 - 24 months at the Boulbinet health center. Methodology: This was a prospective descriptive study lasting six (06) months from May 5 to October 5, 2018. The study included all children aged 0 to 24 months. Results: Acute malnutrition in children aged 0 - 24 months accounted for 2.11% of cases. The sex ratio was 1.41 in favor of males. The mean age of our patients was 5 months 7 days, with extremes of 1 month and 6 months. The majority came from Ra toma (40.24%). Exclusive breastfeeding was most common (54.02%). The main clinical signs were: pallor 49.42%, diarrhea 46.67, oral lesions37.96%. SAM represented 89.66% and MAM 10.34%. Most associated pathologies: anemia 49.42% and oral candidiasis 37.93%. In terms of outcome, we recorded 56.32% cures, 20.69% deaths, 18.39% dropouts and 4.60% cures. Conclusion: Improving the quality of care for malnourished children aged 0 - 24 months requires raising awareness among mothers and the general public of the consequences of malnutrition.展开更多
Purpose: Few studies have evaluated the association between malnutrition and the risk of preoperative deep vein thrombosis (DVT) in patients undergoing primary total joint arthroplasty. This study aimed to investigate...Purpose: Few studies have evaluated the association between malnutrition and the risk of preoperative deep vein thrombosis (DVT) in patients undergoing primary total joint arthroplasty. This study aimed to investigate the prevalence of preoperative DVT in Japanese patients undergoing total knee arthroplasty (TKA) and the importance of malnutrition in the risk of preoperative DVT. Methods: We retrospectively analyzed 394 patients admitted for primary TKA at our institution between January 2019 and December 2023. All patients scheduled for TKA at our institution had serum D-dimer levels measured preoperatively. Lower-limb ultrasonography was examined to confirm the presence of DVT in patients with D-dimer levels ≥ 1.0 µg/mL or who were considered to be at high risk of DVT by the treating physician. Based on the results of lower-limb ultrasonography, all patients were divided into the non-DVT and DVT groups. The incidence of and risk factors for preoperative DVT were investigated, as well as the correlation of DVT with the patient’s nutritional parameters. We used two representative tools for nutritional assessment: the Geriatric Nutritional Risk Index (GNRI) and Controlling Nutritional Status Score. Results: The mean age was 77.8 ± 6.9 years. Preoperative DVT was diagnosed in 57 of the 394 (14.5%) patients. Multivariate logistic regression analysis showed that advanced age and malnutrition status, assessed using the GNRI, were independent risk factors for preoperative DVT. Conclusion: A high incidence of preoperative DVT was observed in patients who underwent TKA. Malnutrition status, as assessed using the GNRI, increased the risk of preoperative DVT. Our findings suggest that clinicians should consider these factors when tailoring preventive strategies to mitigate DVT risk in patients undergoing TKA.展开更多
Introduction: Malnutrition is an important reason for consultation in Mali’s health facilities and remains a major public health problem. The aim of this study was to describe the epidemioclinical profile and associa...Introduction: Malnutrition is an important reason for consultation in Mali’s health facilities and remains a major public health problem. The aim of this study was to describe the epidemioclinical profile and associated factors with performance indicators of integrated management of severe acute malnutrition in children aged 06 to 59 months. Methodology: this was a cross-sectional study with retrospective data collection (January 2021 to December 2022). All children hospitalized for severe acute malnutrition in the pediatric department and whose medical records were usable were included. Data collected using a standardized questionnaire was analyzed with SPSS Version 20 software. Results: A total of 534 children were included. The 12 to 23 months age group (49.1%) and the female sex (53.18%) were the most affected. Fully vaccinated children by age represented 49.4%. The predominant form of malnutrition was marasmus (77.7%). Diarrhea/vomiting (30.3%), fever (18.4%) and cough (15.5%) were the main reasons for consultations. Cure, discontinuation and death rates were 78.5%, 2.1% and 9.2%, respectively. On univariate analysis, the factors statistically associated with performance indicators (cure, drop-out, death) were gastroenteritis (P-value Conclusion: This study reveals that the frequency of severe acute malnutrition remains high at the Kalaban Coro reference health center. Better prevention of illnesses such as malaria, gastroenteritis, and respiratory infections, as well as timely referral, could help facilitate its management.展开更多
Introduction: Superior mesenteric artery syndrome (SMAS), a rare diagnosis due to compression of the third duodenum between the superior mesenteric artery (SMA) and the aorta resulting in bowel obstruction, may lead t...Introduction: Superior mesenteric artery syndrome (SMAS), a rare diagnosis due to compression of the third duodenum between the superior mesenteric artery (SMA) and the aorta resulting in bowel obstruction, may lead to severe malnutrition. We report two cases of patients hospitalised in the Internal Medicine, Endocrinology, Diabetology, and Nutrition Department of the National Hospital Center (NHC) of Pikine. Observations: Patient 1: A 35-year-old female was referred for an aetiological diagnosis due to a rapid weight loss of 15 kilograms in one month, accompanied by persistent vomiting, following an appendectomy performed a month before admission. Upon clinical examination, she presented severe malnutrition (Buzby index of 76%), early post-prandial chronic vomiting, and a poor general condition. An abdominal CT scan revealed aortomesenteric clamp syndrome (AMCS) with an angulation between the aorta and the SMA of 13˚. The underlying cause in this patient was severe malnutrition. Fortunately, her condition improved with medical treatment. Patient 2: We report the case of a 30-year-old female hospitalized due to unusual weight-bearing post-prandial epigastric pain and intermittent vomiting over the past six months. Upon physical examination at admission, she exhibited severe malnutrition with a body mass index (BMI) of 14 kg/m<sup>2</sup>, a Buzby index of 71%, trophic disorders, and a stage IV general condition assessment according to the World Health Organization (WHO). An abdominal CT scan revealed AMCS with an angle between the aorta and the SMA of 22˚ and an aortomesenteric space of 4 mm. The outcome was poor with medical treatment failure and, unfortunately, the patient died before surgery. Conclusion: SMAS is rarely evoked in clinical practice despite the presence of contributing factors and suggestive clinical signs. The prognosis depends on management time.展开更多
Introduction: Severe acute malnutrition remains one of the most important causes of under-five mortality. In Cameroon, the northern regions have the highest prevalence, with 1.4% in the Far North in 2021. These childr...Introduction: Severe acute malnutrition remains one of the most important causes of under-five mortality. In Cameroon, the northern regions have the highest prevalence, with 1.4% in the Far North in 2021. These children are managed at the Internal therapeutic and Nutrional Centre, one of which is located at Maroua Regional Hospital, the third level referral Hospital. We therefore proposed to carry out a study on the clinical and evolutive aspects of these children. Materials and Methods: it was a descriptive, cross-sectional study from January 2020 to December 2022, at the ITNC (CNTI) of Maroua Regional Hospital. The sample size was obtained from the Lorentz formula. Patient records were used for data collection. We excluded all incomplete records and patients with less than 24 hours of admission. Results: Out of the 873 patients we recruited, the prevalence of severe malnutrition was estimated at 18 %. The average age was 14 months, with a male predominance. The main reasons for consultation were fever (42%) and diarrhoea (35%). Marasmus was the predominant clinical form. The major medical complications were sepsis (32.9%) and malaria (16.8%). HIV prevalence was 2.5% and tuberculosis was 4.9%. Most patients had haemoglobin levels between 7 and 10g/dl. 79.3% were cured and 6.5% died. The main causes of death were sepsis and malaria. Conclusion: Severe acute malnutrition remains a major problem in the Far North region. Several joint actions are needed to break this cycle.展开更多
Background:Themortality burden of patients with gastrointestinalmalignancies is increasing worldwide,suggesting the need formore effective prognostic indicators.This study utilized a prospective cohort to(1)analyze th...Background:Themortality burden of patients with gastrointestinalmalignancies is increasing worldwide,suggesting the need formore effective prognostic indicators.This study utilized a prospective cohort to(1)analyze the relationship between frailty and malnutrition and their association with the overall survival(OS)in adults with gastrointestinal cancer and(2)explore which specific frailty-related factors most significantly affect the OS.Methods:Participants diagnosed with gastrointestinal cancer from 2013 to 2018 who were enrolled in the Investigation on Nutrition Status and Clinical Outcome of Common Cancers study were identified.Malnutrition was determined using the Patient-Generated Subjective Global Assessment,whereas frailty was assessed using the FRAIL scale.The main outcome measured was the all-cause mortality.Multivariable-adjusted logistic regression was used to analyze the cross-sectional link between the nutritional status and frailty.Univariate and multivariate Cox regression analyses were conducted to explore the longitudinal association of these with the OS.Results:Among the 4,361 patients enrolled in the study,1,136 deaths were observed over a median follow-up of 43.4 months.Malnourished patients had a significantly higher risk of frailty than well-nourished patients(OR=6.25,95%CI=5.23–7.51).Frailty and malnutrition independently predicted the OS,with frailty showing an HR of 1.50(95%CI=1.33–1.69)and malnutrition showing an HR of 1.51(95%CI=1.31–1.74).Patientswith both frailty andmalnutrition had the highest all-causemortality risk(HR=1.82,95%CI=1.55–2.14)compared with patients with neither risk factor.Mortality rates rose with the accumulation of additional frailty-related factors.Conclusions:Malnutrition and frailty are interrelated prognostic factors in patients with gastrointestinalmalignancies,and their simultaneous presence worsens the patient outcomes.Higher scores for resistance and ambulation are major factors associated with a poorer outcome.Future large-scale prospective studies with repeated measurements are necessary to further explore the complex associations among frailty,malnutrition,and the prognosis in patients with gastrointestinal cancer.展开更多
Scalp necrosis is uncommon in malnourished children,yet temporal catheterization is frequently observed in pediatric hospital settings.The condition is characterized by a black,hard,and unresponsive scalp.Etiologies s...Scalp necrosis is uncommon in malnourished children,yet temporal catheterization is frequently observed in pediatric hospital settings.The condition is characterized by a black,hard,and unresponsive scalp.Etiologies such as temporal arteritis,burns,and Takayasu’s disease,have been proposed.There is a decline in the use of peripheral catheter monitoring in hospitals.War-related food shortages and social instability significantly affect the trauma and risks that undermine the health,social,and psychological well-being of children.This report describes the case of a 5-month-old infant suffering from severe acute malnutrition following the abduction and subsequent release of his mother by armed individuals after one and a half weeks.The infant,who underwent temporal catheterization for medication administration,presented with extensive scalp necrosis.The necrotic tissue was surgically removed,and the malnutrition was successfully treated,resulting in a favorable clinical outcome.The mother received comprehensive mother-child care from a psychologist.展开更多
Objective:This study aims to identify the factors influencing moderate to severe malnutrition in elderly lung cancer patients undergoing chemotherapy and to provide a basis for developing clinical prevention and inter...Objective:This study aims to identify the factors influencing moderate to severe malnutrition in elderly lung cancer patients undergoing chemotherapy and to provide a basis for developing clinical prevention and intervention strategies.Methods:The clinical data of 150 elderly lung cancer patients who received chemotherapy were retrospectively analyzed.Demographic data,clinical characteristics,laboratory indicators,treatment plans,and other relevant information were collected.Independent risk factors for moderate to severe malnutrition during chemotherapy were identified.Results:During chemotherapy,50 patients(33.33%)developed moderate to severe malnutrition.The BMI of patients with moderate to severe malnutrition was significantly lower than that of patients with no or mild malnutrition(21.20±1.60 vs.26.14±2.31,P<0.001),and the proportion of patients with stage IV tumors was significantly higher(60.00%vs.27.00%,P<0.001).Serum pre-albumin(pre-ALB)and hemoglobin(Hb)levels in patients with moderate to severe malnutrition were significantly lower than those in patients with no or mild malnutrition(152.67±30.41 g/L vs.252.47±51.24 g/L and 102.44±10.09 g/L vs.154.21±15.18 g/L,respectively,P<0.001 for all).Conclusion:Low BMI,decreased serum pre-ALB levels,and decreased serum Hb levels before chemotherapy are independent risk factors for moderate to severe malnutrition in elderly lung cancer patients during chemotherapy.Close clinical attention should be given to these patients,with early intervention measures such as nutritional support to reduce the incidence of malnutrition and improve patients’quality of life and prognosis.展开更多
Primary biliary cholangitis(PBC)is a chronic cholestatic liver disease that is associated with impaired biliary excretion processes.Along with the development of cholestasis,there is a deficient flow of bile acids int...Primary biliary cholangitis(PBC)is a chronic cholestatic liver disease that is associated with impaired biliary excretion processes.Along with the development of cholestasis,there is a deficient flow of bile acids into the intestinal lumen causing malnutrition(MN)that is manifested in deficiencies of both macro-and micronutrients.The mechanism for development of trophological insufficiency is multifactorial.However,the trigger of MN in PBC is impaired enterohepatic circulation of bile acids.The ingress of bile acids with a detergent effect into the general bloodstream,followed by elimination via the kidneys and skin,triggers a cascade of metabolic disturbances,which leads to the gradual development and progression of calorie MN.The latter gradually transforms into protein-calorie MN(PСM)(as marasmus)due to the insufficient entry of bile acids into the duodenum,which is accompanied by a decrease in the emulsification,hydrolysis,and absorption of fats and fat-soluble vitamins,as well as disturbance of intestinal motility and bacterial overgrowth.Fat-soluble vitamin deficiencies complement PСM with vitamin and mineral MN.The development of hepatocellular failure enhances the progression of PСM due to the impaired protein synthetic function of hepatocytes in the advanced stage of PBC,which results in deficiency of not only the somatic but also the visceral pool of proteins.A mixed PСM form of marasmus and kwashiorkor develops.Early recognition of energy,protein,micronutrient,and macronutrient deficiencies is of great importance because timely nutritional support can improve liver function and quality of life in patients with PBC.In this case,it is important to know what type(energy,proteincalorie,vitamin,and vitamin-mineral)and form(marasmus,marasmuskwashiorkor)of MN is present in the patient and how it is associated with the stage of the disease.Therefore,it is recommended to screen all patients with PBC for MN,from the early asymptomatic stage of the disease in order to identify and avoid preventable complications,such as fatigue,malaise,performance decrement,sarcopenia,osteoporosis,and hepatic encephalopathy,which will be able to provide appropriate nutritional support for correction of the trophological status.展开更多
Objective According to literature,cancer patients have the highest incidence of malnutrition among hospital patients(40%-80%).Despite this high prevalence,this condition is still under-diagnosed.The aim of this study ...Objective According to literature,cancer patients have the highest incidence of malnutrition among hospital patients(40%-80%).Despite this high prevalence,this condition is still under-diagnosed.The aim of this study was to conduct a systematic literature review and meta-analysis to assess the diagnostic performance of the Malnutrition Screening Tool(MST),a simple tool that can be applied in a busy setting where a comprehensive assessment at screening would be impractical.Methods PubMed,EMBASE and Cochrane central register of controlled trials were systematically searched to identify records relevant to the research question.The QUADAS-2 was used to assess the quality of each included study and the meta-analysis was conducted using the hierarchical bivariate model in STATA.Results Seven records were included in this study and the overall sensitivity specificity,diagnostic odds ratio(DOR).The pooled sensitivity and specificity generated after the meta-analysis in STATA were 0.78(95%CI:0.64-0.88)and 0.82(95%CI:0.76-0.87),respectively.The corresponding DOR was 16.33(95%CI:7.08-37.67).The positive likelihood ratio(LR+)was+4.39(95%CI:3.02-6.38),and the negative likelihood ratio(LR-)were 0.27(95%CI:0.16-0.47)and the 1/LR-3.72(2.14-6.46).Conclusion These results showed that the MST provides weak diagnostic evidence when used to screen for malnutrition in adult cancer patients.展开更多
Background:The Global Leadership Initiative on Malnutrition(GLIM)has been used in China since 2019.This study aimed to test the use of the GLIM criteria in Chinese cancer patients and to compare the diagnostic perform...Background:The Global Leadership Initiative on Malnutrition(GLIM)has been used in China since 2019.This study aimed to test the use of the GLIM criteria in Chinese cancer patients and to compare the diagnostic performance of the GLIM criteria with the Patient-Generated Subjective Global Assessment(PG-SGA)and modified PG-SGA(mPG-SGA). Methods:A total of 2,000 cancer patients were consecutively screened using the Nutritional Risk Screening 2002 instrument on ad-mission.Patients at nutritional risk(Nutritional Risk Screening 2002 score≥3)were enrolled to obtain the complete GLIM,PG-SGA,and mPG-SGA criteria.To evaluate the convergent validity,Spearman correlation analysis was used to compare the test-retest reliability of the GLIM criteria and its results with the scores of various nutritional tools and objective parameters.Kruskal-Wallis tests and χ2 tests were used to test the discriminant validity among groups with different nutritional status.We calculated the sensitivity,specificity,positive predictive value,and negative predictive value for the various tools. Results:There were 562 patients found to be at nutritional risk,accounting for 28.1%of all patients.One hundred seventy-four patients(8.7%)were diagnosed as moderately malnourished,and 333 patients(16.6%)were severely malnourished based on the PG-SGA.When assessed using the GLIM criteria,185 patients(9.3%)were diagnosed as moderately malnourished and 311 patients(15.5%)were severely malnourished.The content validity of the GLIM criteria was 95%,evaluated by 60 medical staff members.The test-retest reliability was good.For the diagnosis of malnutrition versus the PG-SGA,the sensitivity of the GLIM was"good"(90.5%;95%confidence interval[95%CI]=88.0%-93.1%),with a positive predictive value of 92.5%(95%CI=90.2%-94.9%),but the spec-ificity and negative predictive value were"poor."Similar results were obtained when the mPG-SGA was used as the criterion. Conclusions:Overall,this cross-sectional study suggests that the GLIM criteria comprise a valid and reliable tool to assess the nutri-tional status of Chinese cancer patients.展开更多
文摘Background: Malnutrition, a serious public health concern, is influenced by various factors. Objective: The study aims to explore malnutrition issues among infants under five years old in Guéra Province. Methods: The study used a cross-sectional design and a two-stage cluster sampling method to select participants. The study population was infants aged between 0 - 24 months. Data collection was done between June 2023 and September 2024;it included anthropometric measurements, blood analyses, and interviews. Anthropometric parameters were calculated using ENA for SMART software. Statistical analyses were performed by R Studio to investigate associations between different characteristics, using logistic regression models to identify risk factors. A p-value less than 0.05 was considered significant. Results: The study included 377 infants in eight villages in Guéra Province, Chad. The sample was predominantly girls (55.3%), with a median age of 16 months. Most infants (94%) were mixed-fed, and only 6% were exclusively breastfed. We found that 7.3% of children were globally malnourished, with higher rates in boys 9.6%. A significant disparity existed between boys and girls in global acute malnutrition (GAM) rates, with boys having a higher prevalence of 17.9%. A substantial proportion of Infants were underweight, with males 27.4%. Stunting was prevalent 20.1%. Several factors were associated with malnutrition, including gender, feeding practices, infectious diseases, and socioeconomic factors. Diarrhea, malaria, limited access to drinking water, and early diet diversification were significantly associated with malnutrition. Conclusion: Targeted interventions are necessary to address these issues and improve the nutritional status of children in the Guéra province.
文摘Background: Severe acute malnutrition (SAM) is one of the major public health problems associated with increased mortality in under-five children. In low-income countries, renal dysfunction (RD) contributes to about 34% mortality in under-five children with severe acute malnutrition. This study aimed to determine the impacts of severe acute malnutrition on the kidney among the admitted under-five children. Methods: In this prospective longitudinal observational study, a total of 190 children aged 6 to 59 months were enrolled from Iringa and Dodoma tertiary hospitals. Socio-demographic, clinical and laboratory data were collected using a structured questionnaire. Estimated Glomerular Filtration Rate (eGFR) and urine albumin creatinine ratio (uACR) were used to determine RD. Data analysis was done using SPSS version 26 and statistical significance was assumed for factors with p-value Results: Out of 190 children with severe acute malnutrition, 36 (19%) had renal dysfunction. Factors associated with RD in malnourished children were the history of local herbs used within one week (AOR = 5.85, 95% CI [1.41, 24.319], p = 0.0152), Acute watery diarrhea with severe dehydration (AOR = 2.15, 95% CI [1.033, 4.711], p = 0.0166), and positive urine leukocytes (AOR = 19.91, 95% CI [4.09, 96.989], p = 0.0002). At three months of follow up, out of 36 children with RD, 20 (55.56%) attained full recovery, while 4 (11.11%) developed chronic kidney disease (CKD). Children with RD had prolonged hospital stays for more than 14 days with a mean 12.25 ± 5.00 days compared to those with no RD with a mean 6.29 ± 1.68 days (p Conclusion: Renal dysfunction is common among children with severe acute malnutrition. It is associated with prolonged hospital stays and increased mortality. Further studies which can determine the burden of RD in children with severe acute malnutrition as compared to those with no severe acute malnutrition are needed.
文摘BACKGROUND Childhood malnutrition contributes over half of the childhood mortality around the world,predominantly in South-Asian and sub-Saharan countries.AIM To summarize the childhood malnutrition epidemiology along with the comorbid factors associated with it and its management within the community.METHODS The data collection process involved conducting a comprehensive search using specific keywords such as child nutrition disorders and India with Boolean operators.The search was conducted in the Scopus and PubMed electronic databases.RESULTS Inadequate energy consumption initiates pathological alterations in the form of growth retardation,fat,visceral,and muscle loss,a reduction in basal metabolic rate,and a significant reduction in total energy expenditure.It has become evident that malnutrition shows an increased prevalence and incidence rate,despite available guidelines for the management of malnutrition.CONCLUSION Malnutrition can be a major player in the establishment of severe infections that result in significant post discharge mortalities in children.Future trials are required to fill the prime gaps in knowledge regarding the identification of other contributory factors in the pathogenesis of malnutrition and postdischarge infection.New biomarkers for early detection of malnutrition should be the priority of the scientific community for the early management of malnutrition.
文摘Malnutrition is not only a prevalent condition among the elderly but also a common comorbidity in elderly people with gastric cancer(GC).Malnutrition is closely linked to high rates of postoperative complications and poor wound healing in elderly GC patients,which may lead to a higher incidence and mor-tality rate of GC.Malnutrition decreases the physical function of elderly GC patients after surgery,severely affecting their postoperative life quality and hindering subsequent treatments.This retrospective study was conducted by Zhao et al,focusing on the clinical baseline data,postoperative complications,and hospitalization times of elderly GC patients who underwent curative gastrectomy.Additionally,the underlying causes of poor outcomes for patients were discussed.This study may provide a solid basis for the clinical treatment of elderly GC patients in the future.Therefore,malnutrition can serve as a negative prognostic factor for curative surgery in GC patients.Addressing malnutrition and its adverse effects can benefit elderly GC patients from surgical treatment.
文摘Introduction: Malnutrition is a major public health problem in Mali, despite the efforts of the government, its technical and financial partners. The aim of this study was to evaluate the integrated management program for acute malnutrition (IMPAM). Methodology: This was a descriptive cross-sectional study that took place from January to December 2020 in the Douentza health district. The study included anyone with at least one malnourished child aged 6 to 59 months in their care who agreed to take part in the study, community health center staff who had given their consent, and the URENI manager at the Douentza reference health center. Data collected via questionnaires were entered into Excel and then analyzed using Epi-Info version 7 software. Results: A total of 138 acutely malnourished children aged 6 - 59 months, including 71 girls (51.45%), 138 accompanying mothers and 11 health workers, were included in our case study. Among the malnourished, 54.34% were in the 12 - 23 months age group and 69.57% had the severe form. 93% of the mothers interviewed were satisfied with the care provided, and all the health staff interviewed stated that community conflicts had an impact on IMPAM’s activities. Cure rates were 81% in Moderate Outpatient Nutritional Recovery and Education Unit (URENAM), 84% in Severe Ambulatory Nutritional Recovery and Education Unit (URENAS) and 92% in Recovery and Intensive Nutritional Education Unit (URENI). Drop-out rates were 19% in URENAM, 16% in URENAS and 0% in URENI. The death rate was 8% in URENI and 0% in URENAM and URENAS. Conclusion: This study confirms the high prevalence of malnutrition in the district (10.54%). It also reveals that factors such as inter-community conflict and insecurity have seriously affected the IMPAM program.
文摘Malnutrition refers to the deficiency, imbalances, or excesses in a person’s intake of energy or nutrients [1]. Khan defines anaemia as below level of Haemoglobin in red blood shown by a lower number of functioning red blood cells [2]. The crisis in the North West and South West Regions of Cameroon has led to several negative effects on children’s living conditions. There has been an increase in malnutrition and anaemia in the South West Region and Kumba in particular. The main objective of this study was “to examine the prevalence of malnutrition and anaemia in children ≤ 5 years of age in some conflict-hit areas of Meme Division”. A descriptive cross-sectional study was conducted in 2023 from March to June. We recruited 200 children ≤ 5 years into the study from three hospitals. The regional hospital annex in Kumba, Presbyterian General Hospital Kumba and the Ntam Hospital in Kumba. Socio-demographic factors were assessed using questionnaire, nutritional status was assessed by the use anthropometric measurements and an auto haematology analyser was used to determine anaemia. The overall prevalence of malnutrition in the study area was 40.5%. The prevalence of malnutrition varied significantly (P < 0.001) with the study sites. The overall prevalence of anaemia in the study area was 70.5%. The prevalence of anaemia was not significantly associated with the study sites. The prevalence of Malnutrition and Anaemia in children ≤ 5 years of age is very high in the Kumba municipalities. This could be attributed to the ongoing crisis which has caused a lot of social migrations from rural areas to Urban areas which are safer.
文摘Introduction: Failure to thrive (FTT) occurs when a child’s growth falls below expected standards, typically due to inadequate nutrient intake. Factors include insufficient oral intake, poor nutrient absorption, and increased metabolic demands. Previous studies have shown high malnutrition rates in hospitalized children due to illness-related metabolic demands, decreased appetite, and inadequate intake. Our objective was to assess the growth and nutritional status of children admitted to King Abdullah University Hospital (KAUH) and identify the prevalence of undernutrition and associated factors. Methods: This prospective, cross-sectional cohort study was conducted at KAUH from July to December 2022. We included children aged 2 months to 16 years, excluding those with conditions altering growth parameters. Data were collected through pediatric data sheets, physical examinations, and laboratory tests. Anthropometric measurements were taken, and growth was assessed using CDC growth charts. Nutritional anemia was defined as hemoglobin 16. Results: A total of 111 patients were included (56.8% male, median age 65 months). Most patients had normal height (82%) and weight (86.5%) upon admission. However, 14.4% were stunted, 11.7% were underweight, 14.4% were overweight, and 3.6% were obese. Growth impairment correlated with higher anemia rates (p = 0.042). Nutritional anemia was present in 12% of patients. No significant relation was found between breastfeeding history and growth retardation, but maternal perception of malnutrition correlated well with actual malnutrition. Conclusion: Our study found a malnutrition prevalence of 19.8%, highlighting the need for systematic nutritional screening in hospitalized children. The study’s limitations include its small sample size and specific patient population, suggesting the need for larger, multicenter studies for more generalizable results.
文摘Background: The incidence of femoral intertrochanteric fractures in older adults is higher than that of femoral neck fractures;however, both conditions are often analyzed together as proximal femoral fractures. Considering the difference in treatment, postoperative complication, and mortality risk, these two fractures should be analyzed separately. This study aimed to analyze 1-year mortality and its risk factors in patients with surgically treated femoral intertrochanteric fractures. Methods: Consecutive patients with intertrochanteric fractures who underwent surgical interventions at our institution between January 2017 and December 2021 were retrospectively reviewed. A total of 238 patients were eligible for inclusion in this study. Patients’ demographic and clinical information were retrospectively collected. Patients were divided into the 1-year mortality (n = 16) and survival (n = 222) groups. The incidence of 1-year mortality and its independent risk factors were investigated using univariate and multivariate logistic regression analyses. Results: The mean age of patients was 85.6 ± 8.5 years. The 1-year mortality rate was 6.7% (16/238). Preoperative albumin level, the Geriatric Nutritional Risk Index (GNRI), and malnutrition status (GNRI p = 0.02, p = 0.02, and p = 0.0011, respectively). Multivariate analysis showed that malnutrition status (GNRI p = 0.035) was an independent risk factor for 1-year mortality. Conclusion: Malnutrition status assessed using GNRI (GNRI < 92) was an independent risk factor for 1-year mortality. Our findings suggest that GNRI may be an effective screening tool for predicting postoperative 1-year mortality of patients with surgically treated femoral intertrochanteric fractures.
文摘Introduction: Child malnutrition is a major public health problem in Côte d’Ivoire in sub-Saharan Africa. This study aimed to determine the prevalence and factors influencing malnutrition in children under five in the peri-urban area of Abidjan, the economic capital. Patients and Methods: We carried out a prospective cross-sectional analytical study from May 3rd to October 31st 2019 at the General Hospital of Yopougon Attié in a peri-urban district of Abidjan, the economic capital. The study included 522 children aged 0 to 59 months who were received for a consultation, with the informed consent of their parents. The assessment of nutritional status was based on WHO growth standards. Statistical comparisons were made using the Chi-2 test for a significant p-value below 5%. Results: The population was predominantly female (sex ratio of 0.91) with an average age of 8.21 months and overall modest socio-economic conditions. The prevalence of malnutrition was as follows: 3.45% of malnutrition by excess, including 0.57% of obesity, 16.09% of stunting (5.75% severe), 12.07% of underweight (3.45% severe), 8.04% emaciation (1.91% severe). Three risk factors were identified for default malnutrition: age less than 6 months (p = 0.022), low birth weight (p = 0.003), and prematurity (p Conclusion: Malnutrition by deficiency is common in peri-urban areas in Abidjan with the main risk factors being age less than 6 months, low birth weight and prematurity. Fighting against those risk factors could help improve the nutritional status of children under five in the peri-urban environment of Abidjan.
文摘Introduction: Malnutrition is a pathological state resulting from the relative deficiency or excess of one or more essential nutrients, whether manifested clinically or detected only by biochemical, anthropometric or physiological analyses. The overall objective was to assess the quality of management of acute malnutrition in children aged 0 - 24 months at the Boulbinet health center. Methodology: This was a prospective descriptive study lasting six (06) months from May 5 to October 5, 2018. The study included all children aged 0 to 24 months. Results: Acute malnutrition in children aged 0 - 24 months accounted for 2.11% of cases. The sex ratio was 1.41 in favor of males. The mean age of our patients was 5 months 7 days, with extremes of 1 month and 6 months. The majority came from Ra toma (40.24%). Exclusive breastfeeding was most common (54.02%). The main clinical signs were: pallor 49.42%, diarrhea 46.67, oral lesions37.96%. SAM represented 89.66% and MAM 10.34%. Most associated pathologies: anemia 49.42% and oral candidiasis 37.93%. In terms of outcome, we recorded 56.32% cures, 20.69% deaths, 18.39% dropouts and 4.60% cures. Conclusion: Improving the quality of care for malnourished children aged 0 - 24 months requires raising awareness among mothers and the general public of the consequences of malnutrition.
文摘Purpose: Few studies have evaluated the association between malnutrition and the risk of preoperative deep vein thrombosis (DVT) in patients undergoing primary total joint arthroplasty. This study aimed to investigate the prevalence of preoperative DVT in Japanese patients undergoing total knee arthroplasty (TKA) and the importance of malnutrition in the risk of preoperative DVT. Methods: We retrospectively analyzed 394 patients admitted for primary TKA at our institution between January 2019 and December 2023. All patients scheduled for TKA at our institution had serum D-dimer levels measured preoperatively. Lower-limb ultrasonography was examined to confirm the presence of DVT in patients with D-dimer levels ≥ 1.0 µg/mL or who were considered to be at high risk of DVT by the treating physician. Based on the results of lower-limb ultrasonography, all patients were divided into the non-DVT and DVT groups. The incidence of and risk factors for preoperative DVT were investigated, as well as the correlation of DVT with the patient’s nutritional parameters. We used two representative tools for nutritional assessment: the Geriatric Nutritional Risk Index (GNRI) and Controlling Nutritional Status Score. Results: The mean age was 77.8 ± 6.9 years. Preoperative DVT was diagnosed in 57 of the 394 (14.5%) patients. Multivariate logistic regression analysis showed that advanced age and malnutrition status, assessed using the GNRI, were independent risk factors for preoperative DVT. Conclusion: A high incidence of preoperative DVT was observed in patients who underwent TKA. Malnutrition status, as assessed using the GNRI, increased the risk of preoperative DVT. Our findings suggest that clinicians should consider these factors when tailoring preventive strategies to mitigate DVT risk in patients undergoing TKA.
文摘Introduction: Malnutrition is an important reason for consultation in Mali’s health facilities and remains a major public health problem. The aim of this study was to describe the epidemioclinical profile and associated factors with performance indicators of integrated management of severe acute malnutrition in children aged 06 to 59 months. Methodology: this was a cross-sectional study with retrospective data collection (January 2021 to December 2022). All children hospitalized for severe acute malnutrition in the pediatric department and whose medical records were usable were included. Data collected using a standardized questionnaire was analyzed with SPSS Version 20 software. Results: A total of 534 children were included. The 12 to 23 months age group (49.1%) and the female sex (53.18%) were the most affected. Fully vaccinated children by age represented 49.4%. The predominant form of malnutrition was marasmus (77.7%). Diarrhea/vomiting (30.3%), fever (18.4%) and cough (15.5%) were the main reasons for consultations. Cure, discontinuation and death rates were 78.5%, 2.1% and 9.2%, respectively. On univariate analysis, the factors statistically associated with performance indicators (cure, drop-out, death) were gastroenteritis (P-value Conclusion: This study reveals that the frequency of severe acute malnutrition remains high at the Kalaban Coro reference health center. Better prevention of illnesses such as malaria, gastroenteritis, and respiratory infections, as well as timely referral, could help facilitate its management.
文摘Introduction: Superior mesenteric artery syndrome (SMAS), a rare diagnosis due to compression of the third duodenum between the superior mesenteric artery (SMA) and the aorta resulting in bowel obstruction, may lead to severe malnutrition. We report two cases of patients hospitalised in the Internal Medicine, Endocrinology, Diabetology, and Nutrition Department of the National Hospital Center (NHC) of Pikine. Observations: Patient 1: A 35-year-old female was referred for an aetiological diagnosis due to a rapid weight loss of 15 kilograms in one month, accompanied by persistent vomiting, following an appendectomy performed a month before admission. Upon clinical examination, she presented severe malnutrition (Buzby index of 76%), early post-prandial chronic vomiting, and a poor general condition. An abdominal CT scan revealed aortomesenteric clamp syndrome (AMCS) with an angulation between the aorta and the SMA of 13˚. The underlying cause in this patient was severe malnutrition. Fortunately, her condition improved with medical treatment. Patient 2: We report the case of a 30-year-old female hospitalized due to unusual weight-bearing post-prandial epigastric pain and intermittent vomiting over the past six months. Upon physical examination at admission, she exhibited severe malnutrition with a body mass index (BMI) of 14 kg/m<sup>2</sup>, a Buzby index of 71%, trophic disorders, and a stage IV general condition assessment according to the World Health Organization (WHO). An abdominal CT scan revealed AMCS with an angle between the aorta and the SMA of 22˚ and an aortomesenteric space of 4 mm. The outcome was poor with medical treatment failure and, unfortunately, the patient died before surgery. Conclusion: SMAS is rarely evoked in clinical practice despite the presence of contributing factors and suggestive clinical signs. The prognosis depends on management time.
文摘Introduction: Severe acute malnutrition remains one of the most important causes of under-five mortality. In Cameroon, the northern regions have the highest prevalence, with 1.4% in the Far North in 2021. These children are managed at the Internal therapeutic and Nutrional Centre, one of which is located at Maroua Regional Hospital, the third level referral Hospital. We therefore proposed to carry out a study on the clinical and evolutive aspects of these children. Materials and Methods: it was a descriptive, cross-sectional study from January 2020 to December 2022, at the ITNC (CNTI) of Maroua Regional Hospital. The sample size was obtained from the Lorentz formula. Patient records were used for data collection. We excluded all incomplete records and patients with less than 24 hours of admission. Results: Out of the 873 patients we recruited, the prevalence of severe malnutrition was estimated at 18 %. The average age was 14 months, with a male predominance. The main reasons for consultation were fever (42%) and diarrhoea (35%). Marasmus was the predominant clinical form. The major medical complications were sepsis (32.9%) and malaria (16.8%). HIV prevalence was 2.5% and tuberculosis was 4.9%. Most patients had haemoglobin levels between 7 and 10g/dl. 79.3% were cured and 6.5% died. The main causes of death were sepsis and malaria. Conclusion: Severe acute malnutrition remains a major problem in the Far North region. Several joint actions are needed to break this cycle.
基金supported by the National Key Research and Development Program (No. 2022YFC2009600, No. 2022YFC2009601)
文摘Background:Themortality burden of patients with gastrointestinalmalignancies is increasing worldwide,suggesting the need formore effective prognostic indicators.This study utilized a prospective cohort to(1)analyze the relationship between frailty and malnutrition and their association with the overall survival(OS)in adults with gastrointestinal cancer and(2)explore which specific frailty-related factors most significantly affect the OS.Methods:Participants diagnosed with gastrointestinal cancer from 2013 to 2018 who were enrolled in the Investigation on Nutrition Status and Clinical Outcome of Common Cancers study were identified.Malnutrition was determined using the Patient-Generated Subjective Global Assessment,whereas frailty was assessed using the FRAIL scale.The main outcome measured was the all-cause mortality.Multivariable-adjusted logistic regression was used to analyze the cross-sectional link between the nutritional status and frailty.Univariate and multivariate Cox regression analyses were conducted to explore the longitudinal association of these with the OS.Results:Among the 4,361 patients enrolled in the study,1,136 deaths were observed over a median follow-up of 43.4 months.Malnourished patients had a significantly higher risk of frailty than well-nourished patients(OR=6.25,95%CI=5.23–7.51).Frailty and malnutrition independently predicted the OS,with frailty showing an HR of 1.50(95%CI=1.33–1.69)and malnutrition showing an HR of 1.51(95%CI=1.31–1.74).Patientswith both frailty andmalnutrition had the highest all-causemortality risk(HR=1.82,95%CI=1.55–2.14)compared with patients with neither risk factor.Mortality rates rose with the accumulation of additional frailty-related factors.Conclusions:Malnutrition and frailty are interrelated prognostic factors in patients with gastrointestinalmalignancies,and their simultaneous presence worsens the patient outcomes.Higher scores for resistance and ambulation are major factors associated with a poorer outcome.Future large-scale prospective studies with repeated measurements are necessary to further explore the complex associations among frailty,malnutrition,and the prognosis in patients with gastrointestinal cancer.
文摘Scalp necrosis is uncommon in malnourished children,yet temporal catheterization is frequently observed in pediatric hospital settings.The condition is characterized by a black,hard,and unresponsive scalp.Etiologies such as temporal arteritis,burns,and Takayasu’s disease,have been proposed.There is a decline in the use of peripheral catheter monitoring in hospitals.War-related food shortages and social instability significantly affect the trauma and risks that undermine the health,social,and psychological well-being of children.This report describes the case of a 5-month-old infant suffering from severe acute malnutrition following the abduction and subsequent release of his mother by armed individuals after one and a half weeks.The infant,who underwent temporal catheterization for medication administration,presented with extensive scalp necrosis.The necrotic tissue was surgically removed,and the malnutrition was successfully treated,resulting in a favorable clinical outcome.The mother received comprehensive mother-child care from a psychologist.
基金Shaanxi Provincial People’s Hospital Grant“Construction and Verification of Malnutrition Risk Prediction Model in Elderly Patients with Lung Cancer Undergoing Chemotherapy”(Grant No.2023HL-14)。
文摘Objective:This study aims to identify the factors influencing moderate to severe malnutrition in elderly lung cancer patients undergoing chemotherapy and to provide a basis for developing clinical prevention and intervention strategies.Methods:The clinical data of 150 elderly lung cancer patients who received chemotherapy were retrospectively analyzed.Demographic data,clinical characteristics,laboratory indicators,treatment plans,and other relevant information were collected.Independent risk factors for moderate to severe malnutrition during chemotherapy were identified.Results:During chemotherapy,50 patients(33.33%)developed moderate to severe malnutrition.The BMI of patients with moderate to severe malnutrition was significantly lower than that of patients with no or mild malnutrition(21.20±1.60 vs.26.14±2.31,P<0.001),and the proportion of patients with stage IV tumors was significantly higher(60.00%vs.27.00%,P<0.001).Serum pre-albumin(pre-ALB)and hemoglobin(Hb)levels in patients with moderate to severe malnutrition were significantly lower than those in patients with no or mild malnutrition(152.67±30.41 g/L vs.252.47±51.24 g/L and 102.44±10.09 g/L vs.154.21±15.18 g/L,respectively,P<0.001 for all).Conclusion:Low BMI,decreased serum pre-ALB levels,and decreased serum Hb levels before chemotherapy are independent risk factors for moderate to severe malnutrition in elderly lung cancer patients during chemotherapy.Close clinical attention should be given to these patients,with early intervention measures such as nutritional support to reduce the incidence of malnutrition and improve patients’quality of life and prognosis.
文摘Primary biliary cholangitis(PBC)is a chronic cholestatic liver disease that is associated with impaired biliary excretion processes.Along with the development of cholestasis,there is a deficient flow of bile acids into the intestinal lumen causing malnutrition(MN)that is manifested in deficiencies of both macro-and micronutrients.The mechanism for development of trophological insufficiency is multifactorial.However,the trigger of MN in PBC is impaired enterohepatic circulation of bile acids.The ingress of bile acids with a detergent effect into the general bloodstream,followed by elimination via the kidneys and skin,triggers a cascade of metabolic disturbances,which leads to the gradual development and progression of calorie MN.The latter gradually transforms into protein-calorie MN(PСM)(as marasmus)due to the insufficient entry of bile acids into the duodenum,which is accompanied by a decrease in the emulsification,hydrolysis,and absorption of fats and fat-soluble vitamins,as well as disturbance of intestinal motility and bacterial overgrowth.Fat-soluble vitamin deficiencies complement PСM with vitamin and mineral MN.The development of hepatocellular failure enhances the progression of PСM due to the impaired protein synthetic function of hepatocytes in the advanced stage of PBC,which results in deficiency of not only the somatic but also the visceral pool of proteins.A mixed PСM form of marasmus and kwashiorkor develops.Early recognition of energy,protein,micronutrient,and macronutrient deficiencies is of great importance because timely nutritional support can improve liver function and quality of life in patients with PBC.In this case,it is important to know what type(energy,proteincalorie,vitamin,and vitamin-mineral)and form(marasmus,marasmuskwashiorkor)of MN is present in the patient and how it is associated with the stage of the disease.Therefore,it is recommended to screen all patients with PBC for MN,from the early asymptomatic stage of the disease in order to identify and avoid preventable complications,such as fatigue,malaise,performance decrement,sarcopenia,osteoporosis,and hepatic encephalopathy,which will be able to provide appropriate nutritional support for correction of the trophological status.
文摘Objective According to literature,cancer patients have the highest incidence of malnutrition among hospital patients(40%-80%).Despite this high prevalence,this condition is still under-diagnosed.The aim of this study was to conduct a systematic literature review and meta-analysis to assess the diagnostic performance of the Malnutrition Screening Tool(MST),a simple tool that can be applied in a busy setting where a comprehensive assessment at screening would be impractical.Methods PubMed,EMBASE and Cochrane central register of controlled trials were systematically searched to identify records relevant to the research question.The QUADAS-2 was used to assess the quality of each included study and the meta-analysis was conducted using the hierarchical bivariate model in STATA.Results Seven records were included in this study and the overall sensitivity specificity,diagnostic odds ratio(DOR).The pooled sensitivity and specificity generated after the meta-analysis in STATA were 0.78(95%CI:0.64-0.88)and 0.82(95%CI:0.76-0.87),respectively.The corresponding DOR was 16.33(95%CI:7.08-37.67).The positive likelihood ratio(LR+)was+4.39(95%CI:3.02-6.38),and the negative likelihood ratio(LR-)were 0.27(95%CI:0.16-0.47)and the 1/LR-3.72(2.14-6.46).Conclusion These results showed that the MST provides weak diagnostic evidence when used to screen for malnutrition in adult cancer patients.
文摘Background:The Global Leadership Initiative on Malnutrition(GLIM)has been used in China since 2019.This study aimed to test the use of the GLIM criteria in Chinese cancer patients and to compare the diagnostic performance of the GLIM criteria with the Patient-Generated Subjective Global Assessment(PG-SGA)and modified PG-SGA(mPG-SGA). Methods:A total of 2,000 cancer patients were consecutively screened using the Nutritional Risk Screening 2002 instrument on ad-mission.Patients at nutritional risk(Nutritional Risk Screening 2002 score≥3)were enrolled to obtain the complete GLIM,PG-SGA,and mPG-SGA criteria.To evaluate the convergent validity,Spearman correlation analysis was used to compare the test-retest reliability of the GLIM criteria and its results with the scores of various nutritional tools and objective parameters.Kruskal-Wallis tests and χ2 tests were used to test the discriminant validity among groups with different nutritional status.We calculated the sensitivity,specificity,positive predictive value,and negative predictive value for the various tools. Results:There were 562 patients found to be at nutritional risk,accounting for 28.1%of all patients.One hundred seventy-four patients(8.7%)were diagnosed as moderately malnourished,and 333 patients(16.6%)were severely malnourished based on the PG-SGA.When assessed using the GLIM criteria,185 patients(9.3%)were diagnosed as moderately malnourished and 311 patients(15.5%)were severely malnourished.The content validity of the GLIM criteria was 95%,evaluated by 60 medical staff members.The test-retest reliability was good.For the diagnosis of malnutrition versus the PG-SGA,the sensitivity of the GLIM was"good"(90.5%;95%confidence interval[95%CI]=88.0%-93.1%),with a positive predictive value of 92.5%(95%CI=90.2%-94.9%),but the spec-ificity and negative predictive value were"poor."Similar results were obtained when the mPG-SGA was used as the criterion. Conclusions:Overall,this cross-sectional study suggests that the GLIM criteria comprise a valid and reliable tool to assess the nutri-tional status of Chinese cancer patients.
