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Malnutrition

Category

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1
42

Refeeding Syndrome

When and how can providing a starving patient nutrition be potentially deadly.  
Jeffrey S. Guy, MD, FACS
about 9 years ago
1
3
118

Metabolism: Starvation versus Stress

<p>Not feeding an injured or ill patient is not that same as a normal individual who is fasting.&nbsp;&nbsp; A pound of weight loss in the stress patient is significantly different than a pound of weight loss in someone on a diet.&nbsp;&nbsp;A basic understanding of stress metabolism is needed prior to a discussion of nutrition.&nbsp; </p>  
Jeffrey S. Guy, MD, FACS
about 9 years ago
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35

Malnutrition

It gives global estimation of malnutrition and definitions and indicators of malnutrition  
sampath kumar
over 6 years ago
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20

Antibiotics to promote growth in children?

Overt infections are a leading cause of death worldwide in children under 5,1 and strategies to prevent and treat infections are a cornerstone of child survival programmes. Recent assessments suggest that despite a net increase in the size of birth cohorts, the number of children dying before their fifth birthday has fallen to 6.6 million (uncertainty range 6.3-7.0 million) per year, a 45% reduction from almost 12 million deaths in 1990.2 In contrast, the fall in undernutrition has been modest at best. An estimated 165 million children under 5 were stunted in 2011 and an estimated 52 million severely wasted; almost 45% of the current burden from child mortality in under 5s can be attributed to malnutrition.3 Although many risk factors for early child mortality are well recognised, the mechanisms underlying chronic enteropathy and growth failure among children in low and middle income countries remain uncertain.4  
www.bmj.com
over 5 years ago
Www.bmj
1
23

Antibiotics to promote growth in children?

Overt infections are a leading cause of death worldwide in children under 5,1 and strategies to prevent and treat infections are a cornerstone of child survival programmes. Recent assessments suggest that despite a net increase in the size of birth cohorts, the number of children dying before their fifth birthday has fallen to 6.6 million (uncertainty range 6.3-7.0 million) per year, a 45% reduction from almost 12 million deaths in 1990.2 In contrast, the fall in undernutrition has been modest at best. An estimated 165 million children under 5 were stunted in 2011 and an estimated 52 million severely wasted; almost 45% of the current burden from child mortality in under 5s can be attributed to malnutrition.3 Although many risk factors for early child mortality are well recognised, the mechanisms underlying chronic enteropathy and growth failure among children in low and middle income countries remain uncertain.4  
bmj.com
over 5 years ago
Www.bmj
1
51

Bariatric surgery for obesity and metabolic conditions in adults

This review summarizes recent evidence related to the safety, efficacy, and metabolic outcomes of bariatric surgery to guide clinical decision making. Several short term randomized controlled trials have demonstrated the effectiveness of bariatric procedures for inducing weight loss and initial remission of type 2 diabetes. Observational studies have linked bariatric procedures with long term improvements in body weight, type 2 diabetes, survival, cardiovascular events, incident cancer, and quality of life. Perioperative mortality for the average patient is low but varies greatly across subgroups. The incidence of major complications after surgery also varies widely, and emerging data show that some procedures are associated with a greater risk of substance misuse disorders, suicide, and nutritional deficiencies. More research is needed to enable long term outcomes to be compared across various procedures and subpopulations, and to identify those most likely to benefit from surgical intervention. Given uncertainties about the balance between the risks and benefits of bariatric surgery in the long term, the decision to undergo surgery should be based on a high quality shared decision making process.  
bmj.com
about 5 years ago
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25

Aetiology and management of malnutrition in HIV-positive children

Stream Aetiology and management of malnutrition in HIV-positive children by BMJ talk medicine from desktop or your mobile device  
SoundCloud
about 5 years ago
Www.bmj
1
30

Leading campaigner for legalising assisted suicide dies from starvation

Debbie Purdy, the leading campaigner and activist for the legalisation of assisted suicide in the United Kingdom, has died at the age of 51 after starving herself to death.  
bmj.com
over 4 years ago
Www.bmj
1
31

Resuscitating drowned children

The World Health Organization published its global report on drowning in November 2014, reporting a staggering 372 000 deaths a year from all types of water immersion. Worldwide, drowning is in the top 10 causes of death in children and young people, particularly in males and those aged under 5. An estimated 21 children and young adults are drowned every hour.1 Other public health matters have had disproportionately greater attention, despite the numbers of deaths from drowning being equivalent to two thirds of global deaths from malnutrition and over one half of deaths from malaria.  
bmj.com
over 4 years ago
%3fr=0
2
129

A Modest Man

The registrar's face was taking on a testy look. So enduring was the silence our furtive glances had developed a nystagmic quality. “Galactosaemia” came her peremptory reply. Right on queue the disjointed chorus of ahs and head nods did little to hide our mental whiteboard of differentials being wiped clean. At the time conjugated bilirubinaemia in children only meant one thing: biliary atresia. A fair assumption; we were sitting in one of three specialist centres in the country equipped to treat these patients. Ironically the condition has become the unwieldy yardstick I now measure the incidence of paediatric disease. Biliary atresia is the most common surgical cause of neonatal jaundice with a reported incidence of 1 in 14-16ooo live births in the West. It is described as a progressive inflammatory obliteration of the extrahapatic bile duct. And Dr Charles West, the founder of Great Ormond Street Hospital, offers an eloquent description of the presenting triad of prolonged jaundice, pale acholic stools and dark yellow urine: ‘Case 18...It was born at full term, though small, apparently healthy. At 3 days however, it began to get yellow and at the end of 3 weeks was very yellow. Her motions at no time after the second day appeared natural on examination, but were white, like cream, and her urine was very high coloured.’ 1855 was the year of Dr West's hospital note. An almost universally fatal diagnosis and it would remain so for the next 100 years. The time's primordial classification of biliary atresia afforded children with the 'noncorrectable' type, a complete absence of patent extrahepatic bile duct, an unfortunate label; they were beyond saving. Having discovered the extent of disease at laparatomy, the surgeons would normally close the wound. The venerable Harvardian surgeon, Robert E. Gross saved an enigmatic observation: “In most instances death followed a downhill course…” K-A-S-A-I read the ward’s board. It was scrawled under half the children's names. I dismissed it as just another devilishly hard acronym to forget. The thought of an eponymous procedure had escaped me and in biliary atresia circles, it's the name everyone should know: Dr Morio Kasai. Originating from Aomori prefecture, Honshu, Japan, Dr Kasai graduated from the National Tohoku University School of Medicine in 1947. His ascension was rapid, having joined the 2nd department of Surgery as a general surgeon, he would assume the role of Assistant Professor in 1953. The department, under the tenure of Professor Shigetsugu Katsura, shared a healthy interest in research. 1955 was the landmark year. Katsura and Kasai operated on their first case: a 72 day old infant. Due to bleeding at the incised porta hepatis, Katsura is said to have 'placed' the duodenum over the site in order to staunch the flow. She made a spectacular postoperative recovery, the jaundice had faded and there was bile pigment in her stool. During the second case, Katsura elected to join the unopened duodenum to the porta hepatis. Sadly the patient's jaundice did not recover, but the post-mortem conducted by Kasai confirmed the development of a spontaneous internal biliary fistula connecting the internal hepatic ducts to the duodenum. Histological inspection of removed extrahepatic duct showed the existence of microscopic biliary channels, hundreds of microns in diameter. Kasai made a pivotal assertion: the transection of the fibrous cord of the obliterated duct must contain these channels before anastomosis with the jejunal limb Roux-en-Y loop. This would ensure communication between the porta hepatis and the intrahepatic biliary system. The operation, entitled hepatic portoenterostomy, was first performed as a planned procedure for the third case at Tohoku. Bile flow was restored and Kasai published the details of the new technique in the Japanese journal Shujutsu in 1959. However, news of this development did not dawn on the West until 1968 in the Journal of Pediatric Surgery. The success of the operation and its refined iterations were eventually recognized and adopted in the 1970s. The operation was and is not without its dangers. Cholangitis, portal hypertension, malnutrition and hepatopulmonary syndrome are the cardinal complications. While diagnosing and operating early (<8 weeks) are essential to the outcome, antibiotic prophylaxis and nutritional support are invaluable prognostic factors. Post operatively, the early clearance of jaundice (within 3 months) and absence of liver cirrhosis on biopsy, are promising signs. At UK centres the survival after a successful procedure is 80%. The concurrent development of liver transplantation boosts this percentage to 90%. Among children, biliary atresia is the commonest indication for transplantation; by five years post-Kasai, 45% will have undergone the procedure. On the 6th December 2008, Dr Kasai passed away. He was 86 years old and had been battling the complications of a stroke he suffered in 1999. His contemporaries and disciples paint a humble and colourful character. A keen skier and mountaineer, Dr Kasai lead the Tohoku University mountain-climbing team to the top of the Nyainquntanglha Mountains, the highest peaks of the Tibetan highlands. It was the first successful expedition of its kind in the world. He carried through this pioneering spirit into his professional life. Paediatric surgery was not a recognized specialty in Japan. By founding and chairing multiple associations including the Japanese Society of Pediatric Surgeons, Dr Kasai gave his specialty and biliary atresia, the attention it deserved. Despite numerous accolades of international acclaim for his contributions to paediatric surgery, Dr Kasai insisted his department refer to his operation as the hepatic portoenterostomy; the rest of the world paid its originator the respect of calling it the ‘Kasia’. Upon completion of their training, he would give each of his surgeons a hand-written form of the word ‘Soshin’ [simple mind], as he believed a modest surgeon was a good one. At 5 foot 2, Kasai cut a more diminutive figure one might expect for an Emeritus Professor and Hospital Director of a university hospital. During the course of his lifetime he had developed the procedure and lived to see its fruition. The Kasia remains the gold standard treatment for biliary atresia; it has been the shinning light for what Willis J. Potts called the darkest chapter in paediatric surgery. It earned Dr Kasai an affectionate but apt name among his peers, the small giant. References Miyano T. Morio Kasai, MD, 1922–2008. Pediatr Surg Int. 2009;25(4):307–308. Garcia A V, Cowles RA, Kato T, Hardy MA. Morio Kasai: a remarkable impact beyond the Kasai procedure. J Pediatr Surg. 2012;47(5):1023–1027. Mowat AP. Biliary atresia into the 21st century: A historical perspective. Hepatology. 1996;23(6):1693–1695. Ohi R. A history of the Kasai operation: Hepatic portoenterostomy for biliary atresia. World J Surg. 1988;12(6):871–874. Ohi R. Morio Kasai, MD 1922-2008. J Pediatr Surg. 2009;44(3):481–482. Lewis N, Millar A. Biliary atresia. Surg. 2007;25(7):291–294. This blog post is a reproduction of an article published in the Medical Student Newspaper, April 2014 issue.  
James Wong
over 5 years ago
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23

How does the body adapt to starvation

Visit us (http://www.khanacademy.org/science/healthcare-and-medicine) for health and medicine content or (http://www.khanacademy.org/test-prep/mcat) for MCAT...  
youtube.com
over 4 years ago
Www.bmj
0
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Leading campaigner for legalising assisted suicide dies from starvation

Debbie Purdy, the leading campaigner and activist for the legalisation of assisted suicide in the United Kingdom, has died at the age of 51 after starving herself to death.  
feeds.bmj.com
over 4 years ago
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Study shows putting aggressive cancer on a starvation diet slows tumour growth

Scientists researching one of Britain's deadliest rare cancers, mesothelioma, at...  
medicalnewstoday.com
over 4 years ago
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Malnutrition in U.S. - greatest cost linked to seniors, depression, COPD, coronary artery disease and dementia

Even in food-abundant industrialized countries like the U.S., an alarming number of people, particularly seniors, are in a state of diseased-associated malnutrition1.  
medicalnewstoday.com
over 4 years ago
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12

Aetiology and management of malnutrition in HIV-positive children

Stream Aetiology and management of malnutrition in HIV-positive children by BMJ talk medicine from desktop or your mobile device  
feeds.bmj.com
over 4 years ago
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11

Powders of iron plus other micronutrients for home (point-of-use) fortification of foods consumed by pregnant women | Cochrane

Pregnant women are particularly vulnerable to nutrient deficiencies due to the requirements of the growing baby during the pregnancy. In low-income countries, many women have diets with low content of vitamins and minerals, and they participate in long hours of physical labour. They are also exposed to recurrent infections, which make nutritional deficiencies worse. Thus, lack of adequate nutrition can contribute to the poor health of these women their babies.  
cochrane.org
over 4 years ago
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Nutritional support in children and young people with cancer undergoing chemotherapy | Cochrane

The provision of safe, appropriate and effective nutritional support for children and young people undergoing treatment for cancer is now well recognised as an important part of their care. It may help to reverse malnutrition seen at diagnosis, prevent malnutrition associated with the cancer, promote weight gain and growth and improve quality of life. Nutritional support may be provided by one of two methods: intravenous nutritional liquids delivered through a central or peripheral vein which bypass the gut (parenteral nutrition); or nutritional liquids or solids that pass through any part of the gut, regardless of method of delivery (e.g. orally or via a tube; enteral nutrition).  
cochrane.org
about 4 years ago
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Nutrition and health in women, children, and adolescent girls

Urgent action is needed to tackle malnutrition in all forms and to help nutrition unlock the potential of investment in the health of women, children, and adolescents, say Francesco Branca and colleagues  
feeds.bmj.com
about 4 years ago
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0
8

South Sudan famine warning: Living on grass and leaves - BBC News

The BBC's Yalda Hakim reports from a village in Kaldak in the remote east of South Sudan to see the impact of the country's civil war, and finds people at risk of famine.  
bbc.co.uk
about 4 years ago