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1.
PLoS One ; 19(1): e0295810, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38215079

RESUMO

BACKGROUND: While child undernutrition has been eliminated in some middle-income countries, it remains highly prevalent in sub-Sahara African (SSA) and South Asian regions, and is disproportionately concentrated among the poor. In this study, we estimated trends in child undernutrition by social determinants and related risks from wealth inequality in Ethiopia, from 2005 to 2016. METHOD: We analyzed data from three consecutive surveys (2005, 2011, and 2016) from the Ethiopian Demographic and Health Survey. First, we estimated trends in the prevalence of childhood undernutrition variables (stunting, underweight, and wasting) and social determinants (household wealth status, education level, place of residence, and administrative regions). Then we assessed evidence of undernutrition by wealth-related inequality with concentration curves (visual) and concentration indeces (quantitative). A multilevel mixed-effect Poisson regression model was used to identify predictors of undernutrition variables expressed as covariate-adjusted rate ratios, with 95% confidence intervals (RRs, 95%CI). RESULT: A total of 23,934 mother-child pairs were obtained from the three surveys. The average prevalence decreased by 12.4 percentage points for stunting (from 50.8 to 38.4%, P<0.01), 9.5 percentage points for underweight (33.2% to23.7%, P<0.01), and 2.1 percentage points for wasting (12.2% to10.1%, P<0.01). There was persistent and statistically evidence of wealth inequality in stunting, underweight, and wasting (concentration indeces of -0.2 to -0.04, all P values <0.05). Stunting, underweight, and wasting variables were associated with male sex of the child (RR 0.94, 0.95, 0.85, all P-values <0.01) recent diarrhea (RR 1.18, 1.27, 1.37, all P-values <0.01), secondary education status of the mother (RR 0.66, 0.57, 0.61, all P-values < 0.057), increasing wealth index (richest) (RR 0.73, 0.70, 0.50, all P-values < 0.05), and having no toilet facility (RR 1.16, 1.22, 1.18, all P-values < 0.05). CONCLUSION: Despite the decreased burden of stunting and underweight, the prevalence of wasting remained relatively unchanged in Ethiopia from 2005 to 2016. Moreover, wealth-related inequality in child undernutrition increased for most of the child undernutrition indicators during this period. Social determinants of child undernutrition warrant urgent implementation of strategies to reduce their health impacts in SSA.


Assuntos
Transtornos da Nutrição Infantil , Desnutrição , Síndrome de Emaciação , Feminino , Humanos , Masculino , Lactente , Magreza/epidemiologia , Determinantes Sociais da Saúde , Síndrome de Emaciação/epidemiologia , Desnutrição/epidemiologia , Transtornos da Nutrição Infantil/epidemiologia , Caquexia , Transtornos do Crescimento/epidemiologia , Prevalência , Inquéritos Epidemiológicos
2.
PLoS One ; 19(1): e0291185, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38271373

RESUMO

Since computed tomography (CT) is a part of standard diagnostic protocol in pancreatic ductal adenocarcinoma (PDAC), we have evaluated the value of CT for sarcopenia screening in patients with PDAC, intending to expand the diagnostic value of tomographic studies. In our study, we included 177 patients with available CT images. Two groups were formed: Group 1 consisted of 117 patients with PDAC in various locations and stages and Group 2, or the control group, consisted of 60 "nominally healthy" patients with other somatic non-oncological diseases. The body mass index (BMI) was defined as a ratio of patient's weight to the square of their height (kg/m2). CT-based body composition analysis was performed using commercially available software with evaluation of sarcopenia using skeletal muscle index (SMI, cm2/m2). Based on the SMI values, sarcopenia was found in 67.5% of patients (79 out of 117) in the first patient group. It was found more frequently in males (42 out of 56; 75%) than in females (37 out of 61; 60.6%). Additionally, we observed a decrease in muscle mass (hidden sarcopenia) in 79.7% in patients with a normal BMI. Even in overweight patients, sarcopenia was found in 50% (sarcopenic obesity). In patients with reduced BMI sarcopenia was found in all cases (100%). Statistically significant difference of SMI between two groups was revealed for both sexes (p = 0,0001), with no significant difference between groups in BMI. BMI is an inaccurate value for the assessment of body composition as it does not reflect in the details the human body structure. As SMI may correlate with the prognosis, decreased muscle mass- especially "hidden" sarcopenia or sarcopenic obesity- should be reported. The use of CT-based evaluation of sarcopenia and sarcopenic obesity will allow for a better treatment response assessment in patients with cancer cachexia.


Assuntos
Carcinoma Ductal Pancreático , Neoplasias Pancreáticas , Sarcopenia , Síndrome de Emaciação , Masculino , Feminino , Humanos , Sarcopenia/diagnóstico , Sarcopenia/diagnóstico por imagem , Caquexia/diagnóstico por imagem , Caquexia/etiologia , Detecção Precoce de Câncer , Músculo Esquelético/diagnóstico por imagem , Músculo Esquelético/patologia , Neoplasias Pancreáticas/complicações , Neoplasias Pancreáticas/diagnóstico por imagem , Obesidade/patologia , Tomografia Computadorizada por Raios X , Carcinoma Ductal Pancreático/patologia , Prognóstico , Síndrome de Emaciação/patologia , Estudos Retrospectivos
3.
Trop Doct ; 54(1): 69-71, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37671547

RESUMO

Scrub typhus is a re-emerging and endemic disease in the Asia Pacific region caused by Orientia tsutsugamushi. We present a 65-year-old male from Sri Lanka who presented with fever, bilateral acute sensorineural hearing loss, and confusion. On examination, he was dehydrated. Significant orthostatic hypotension and an eschar were noted. Investigations revealed hyponatraemia with elevated urine sodium, reduced serum osmolality, and normal urine osmolality suggestive of cerebral salt wasting. After initial hydration with 0.9% NaCl, hyponatraemia was corrected with 3% NaCl. Oral doxycycline was prescribed, and he showed dramatic clinical improvement. A diagnosis of typhus must be considered in a patient presenting with a febrile illness and acute hearing loss. Cerebral salt-wasting disease should be considered in a patient with typhus who develops hyponatraemia with dehydration. Furthermore, acute sensorineural hearing loss in both ears is an important manifestation of the disease.


Assuntos
Perda Auditiva Neurossensorial , Hiponatremia , Doenças Neuromusculares , Orientia tsutsugamushi , Tifo por Ácaros , Tifo Epidêmico Transmitido por Piolhos , Síndrome de Emaciação , Masculino , Humanos , Idoso , Tifo por Ácaros/complicações , Tifo por Ácaros/diagnóstico , Tifo por Ácaros/tratamento farmacológico , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/tratamento farmacológico , Perda Auditiva Neurossensorial/etiologia
4.
Biomed Res ; 44(5): 199-207, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37779032

RESUMO

Myogenesis is required to generate skeletal muscle tissue and to maintain skeletal muscle mass. Decreased myogenesis under various pathogenic conditions results in muscular atrophy. Through a small screening of Japanese traditional (Kampo) medicines, hachimijiogan (HJG) was shown to promote the myogenic differentiation of C2C12 myoblasts through the upregulation of myogenin. In tumor-bearing cancer-cachectic mice, HJG was also found to have a protective effect against cancer-cachectic muscle wasting. This effect was significant when HJG was administered in combination with aerobic exercise by treadmill running. Moreover, HJG ameliorated the cellular atrophy of C2C12 myotubes induced by treatment with conditioned medium derived from a colon-26 cancer cell culture. In addition, HJG suppressed H2O2-dependent myotube atrophy, suggesting that HJG could reverse the atrophic phenotypes by eliminating reactive oxygen species.


Assuntos
Caquexia , Medicina Kampo , Neoplasias , Síndrome de Emaciação , Animais , Camundongos , Neoplasias do Colo/tratamento farmacológico , Peróxido de Hidrogênio/efeitos adversos , Peróxido de Hidrogênio/farmacologia , Fibras Musculares Esqueléticas/patologia , Músculo Esquelético/patologia , Atrofia Muscular/tratamento farmacológico , Atrofia Muscular/etiologia , Atrofia Muscular/patologia , Caquexia/etiologia , Síndrome de Emaciação/etiologia , Neoplasias/complicações , Desenvolvimento Muscular/genética , Desenvolvimento Muscular/fisiologia
5.
PLoS One ; 18(8): e0289933, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37561793

RESUMO

BACKGROUND: Benin ranks as one of the countries in the world with an alarmingly high prevalence of stunting, wasting, and underweight in children under five years. However, limited studies have examined the factors associated with the prevalence of these undernutrition indicators among children under five years in the country. This study aimed to fill this research gap by examining the prevalence rates and factors associated with stunting, wasting, and underweight among this specific population of interest. METHODS: This quantitative study utilised data from the most recent Benin Demographic and Health Survey (BDHS) conducted in 2017-18. The survey employed a nationally representative cross-sectional design and utilised a two-stage stratified cluster sampling technique to select participants. The study included a sample of 13,589 children under the age of five years. The main analytical approach employed was binary logistic regression, which was used to explore the associations between undernutrition (the combined outcome variable representing stunting, wasting, and underweight) and various socio-demographic factors. RESULTS: The combined prevalence of stunting, wasting, and underweight among children under five years in Benin during the 2017-18 survey period was 14.95%. Several factors were significantly associated with these indicators of undernutrition, including female gender (AOR = 0.71, 95% CI = 0.59-0.85), birth weight of 4.1 kg and over (AOR = 0.26, 95% CI = 0.14-0.48), multiple births (AOR = 3.22, 95% CI = 2.11-4.91), and a child's experience of diarrhoea (AOR = 1.76, 95% CI = 1.40-2.20). Furthermore, the prevalence of these undernutrition indicators was higher among children whose mothers had lower levels of education (AOR = 0.82, 95% CI = 0.01-0.42) and were unmarried (AOR = 0.67, 95% CI = 0.49-0.93). CONCLUSIONS: This present study confirms that undernutrition rates are elevated in Benin and are closely linked to perinatal factors such as birth weights and multiple births, postnatal health conditions including diarrheal episodes, and socio-demographic determinants such as a child's gender, maternal education level, and marital status. Therefore, there is the need to consider specific modifiable factors, such as low birth weight, episodes of child diarrhoea, and maternal education as priority targets for child nutrition interventions in Benin.


Assuntos
Desnutrição , Síndrome de Emaciação , Gravidez , Humanos , Criança , Feminino , Lactente , Pré-Escolar , Magreza/epidemiologia , Prevalência , Estudos Transversais , Benin/epidemiologia , Síndrome de Emaciação/epidemiologia , Desnutrição/epidemiologia , Mães , Transtornos do Crescimento/epidemiologia , Caquexia , Peso ao Nascer
6.
Semin Nephrol ; 43(2): 151403, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-37541069

RESUMO

Protein energy wasting(PEW) is a term that most nephrologists used to define nutritional disorders in patients with acute kidney injury and chronic kidney disease. Although this nomenclature is well implemented in the field of nephrology, the use of other terms such as cachexia or malnutritionin the majority of chronic diseases can induce confusion regarding the definition and interpretation of these terms. There is ample evidence in the literature that the pathways involved in cachexia/malnutrition and PEW are common. However, in kidney diseases, there are pathophysiological conditions such as accumulation of uremic toxins, and the use of dialysis, which may induce a phenotypic specificity justifying the original term PEW. In light of the latest epidemiologic studies, the criteria for PEW used in 2008 probably need to be updated. The objective of this review is to summarize the main mechanisms involved in cachexia/malnutrition and PEW. We discuss the need to modernize and simplify the current definition and diagnostic criteria of PEW. We consider the interest of proposing a specific nomenclature of PEW for children and elderly patients with kidney diseases.


Assuntos
Desnutrição , Desnutrição Proteico-Calórica , Insuficiência Renal Crônica , Síndrome de Emaciação , Criança , Humanos , Idoso , Caquexia/diagnóstico , Caquexia/etiologia , Síndrome de Emaciação/diagnóstico , Desnutrição Proteico-Calórica/diagnóstico , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/diagnóstico , Diálise Renal
7.
Glob Health Action ; 16(1): 2240158, 2023 12 31.
Artigo em Inglês | MEDLINE | ID: mdl-37497693

RESUMO

BACKGROUND: Undernutrition remains a major public health issue in low- and middle-income countries. Objective Our aim for this study was to identify the factors contributing to undernutrition in children under five years old in North Africa. METHODS: We searched five electronic bibliographic databases (Ovid MEDLINE, Web of Science, Embase (Ovid), ProQuest, and CINAHL) for eligible observational studies published after 2006. STATA version 17 software was used to calculate the odds ratios between associated factors and indicators of undernutrition, with 95% confidence intervals. For each factor, the overall odds were pooled using a forest plot. Due to the significant heterogeneity among the studies (I2 > 50%), a random-effects model was used, and sensitivity analysis was conducted to examine the effect of outliers. RESULTS: Out of 1093 initially identified studies, 14 met the selection criteria. Our meta-analysis revealed that uneducated mothers were the most common factor associated with undernutrition in North African children. Children aged 0-23 months were significantly associated with stunting (odds ratios (OR) = 1.27; 95% CI: 1.18; 1.37) and wasting (OR = 1.68; 95% CI: 1.42; 1.99). Children living in rural areas were also at higher odds of being stunted (OR = 1.74; 95% CI: 1.64; 1.84) and underweight (OR = 1.59; 95% CI: 1.35; 1.88). These analyses also indicated that a lower wealth index, mothers' nutritional health, uneducated fathers, and low birth weight were other factors significantly associated with stunting. CONCLUSION: Addressing undernutrition in Northern Africa requires a multidisciplinary approach prioritising mothers and young children, especially families in underprivileged areas.


Assuntos
Desnutrição , Síndrome de Emaciação , Feminino , Humanos , Criança , Lactente , Pré-Escolar , Desnutrição/epidemiologia , Mães , Magreza , Transtornos do Crescimento/epidemiologia , Transtornos do Crescimento/etiologia , Prevalência , África do Norte/epidemiologia
8.
PLoS One ; 18(7): e0282550, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37498849

RESUMO

Sea star wasting syndrome (SSWS) can cause widespread mortality in starfish populations as well as long-lasting changes to benthic community structure and dynamics. SSWS symptoms have been documented in numerous species and locations around the world, but to date there is only one record of SSWS from the Antarctic and this outbreak was associated with volcanically-driven high temperature anomalies. Here we report outbreaks of SSWS-like symptoms that affected ~30% of individuals of Odontaster validus at two different sites in McMurdo Sound, Antarctica in 2019 and 2022. Unlike many SSWS events in other parts of the world, these outbreaks were not associated with anomalously warm temperatures. Instead, we suggest they may have been triggered by high nutrient input events on a local scale. Although the exact cause of these outbreaks is not known, these findings are of great concern because of the keystone role of O. validus and the slow recovery rate of Antarctic benthic ecosystems to environmental stressors.


Assuntos
Ecossistema , Síndrome de Emaciação , Humanos , Animais , Regiões Antárticas , Estrelas-do-Mar , Caquexia
9.
Asia Pac J Public Health ; 35(6-7): 420-428, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37501321

RESUMO

This study assessed whether enrollment in a national conditional cash transfer program was associated with wasting and stunting among children experiencing extreme poverty in the Philippines. Data were drawn from cross-sectional surveys collected from 10 regional areas in the Philippines between April 2018 and May 2019. A total of 2945 children aged between six months and 12 years comprised the analytical sample. Multilevel logistic regression was conducted to estimate the association between enrollment in Pantawid Pamilyang Pilipino Program (4Ps) and stunting and wasting, controlling for sociodemographic factors and clustering by region. There was no meaningful association between household enrollment in 4Ps and the wasting status of children, but enrollment in 4Ps was associated with lower odds of stunting and differed by geography type. Findings suggest that the current design of 4Ps may not address sudden shocks that contribute to wasting, but may address the underlying socioeconomic risk factors associated with stunting.


Assuntos
Desnutrição , Síndrome de Emaciação , Criança , Humanos , Lactente , Estudos Transversais , Filipinas/epidemiologia , Pobreza , Fatores Socioeconômicos , Transtornos do Crescimento/epidemiologia , Prevalência , Desnutrição/epidemiologia
11.
Clin Nutr ; 42(8): 1475-1479, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37302879

RESUMO

In 2010, the definition of cachexia was jointly developed by the European Society for Clinical Nutrition and Metabolism (ESPEN) Special Interest Groups (SIG) "Cachexia-anorexia in chronic wasting diseases" and "Nutrition in geriatrics". Cachexia was considered as a synonym of disease-related malnutrition (DRM) with inflammation by the ESPEN guidelines on definitions and terminology of clinical nutrition. Starting from these concepts and taking into account the available evidence the SIG "Cachexia-anorexia in chronic wasting diseases" conducted several meetings throughout 2020-2022 to discuss the similarities and differences between cachexia and DRM, the role of inflammation in DRM, and how it can be assessed. Moreover, in line with the Global Leadership Initiative on Malnutrition (GLIM) framework, in the future the SIG proposes to develop a prediction score to quantify the individual and combined effect(s) of multiple muscle and fat catabolic mechanisms, reduced food intake or assimilation and inflammation, which variably contribute to the cachectic/malnourished phenotype. This DRM/cachexia risk prediction score could consider the factors related to the direct mechanisms of muscle catabolism separately from those related to the reduction of nutrient intake and assimilation. Novel perspectives in the field of DRM with inflammation and cachexia were identified and described in the report.


Assuntos
Desnutrição , Síndrome de Emaciação , Humanos , Caquexia/etiologia , Anorexia , Avaliação Nutricional , Desnutrição/complicações , Estado Nutricional , Inflamação/complicações
12.
BMJ Open ; 13(6): e070480, 2023 06 12.
Artigo em Inglês | MEDLINE | ID: mdl-37308267

RESUMO

OBJECTIVES: The objectives of this study are to identify the trend of undernutrition risk among under-five children (U5C) in Bangladesh and the trend of its correlates. DESIGN: Multiple cross-sectional data sets from different time points were used. SETTING: Nationally representative Bangladesh Demographic and Health Surveys (BDHSs) were conducted in 2007, 2011, 2014 and 2017/2018. PARTICIPANTS: In the BDHSs, the sample sizes for ever-married women (age: 15-49 years) were 5300 in 2007, 7647 in 2011, 6965 in 2014 and 7902 in 2017/2018. OUTCOMES: Extant indicators of undernutrition (stunted, wasted and underweight) have been considered as the outcome variables. MATERIALS AND METHODS: Descriptive statistics, bivariate analysis and factor loadings from factor analysis have been used to determine the prevalence of undernutrition over the years and find the trend of risk and its correlates. RESULTS: Risks of stunting among the U5C were 41.70%, 40.67%, 36.57% and 31.14%; that of wasting were 16.94%, 15.48%, 14.43% and 8.44%; and that of underweight were 39.79%, 35.80%, 32.45% and 22.46% in 2007, 2011, 2014 and 2017/2018, respectively. From the factor analysis, it has been found that the top five potential correlates of undernutrition are the wealth index, the education of the father and mother, the frequency of antenatal visits during pregnancy, the father's occupation and/or the type of place of residence in the last four consecutive surveys. CONCLUSION: This study helps us gain a better understanding of the impact of the top correlates on child undernutrition. To accelerate the reduction of child undernutrition more by 2030, Government and non-government organisations should focus on improving education and household income-generating activities among poor households and raising awareness among women about the importance of receiving antenatal care during pregnancy.


Assuntos
Desnutrição , Humanos , Feminino , Gravidez , Recém-Nascido , Lactente , Pré-Escolar , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Masculino , Bangladesh/epidemiologia , Desnutrição/complicações , Desnutrição/epidemiologia , Síndrome de Emaciação/epidemiologia , Síndrome de Emaciação/etiologia , Magreza/epidemiologia , Magreza/etiologia , Transtornos do Crescimento/epidemiologia , Transtornos do Crescimento/etiologia , Cuidado Pré-Natal/estatística & dados numéricos , Fatores de Risco , Demografia , Análise Fatorial
13.
PLoS One ; 18(6): e0286384, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37294819

RESUMO

Long-term datasets can reveal otherwise undetectable ecological trends, illuminating the historical context of contemporary ecosystem states. We used two decades (1997-2019) of scientific trawling data from a subtidal, benthic site in Puget Sound, Washington, USA to test for gradual trends and sudden shifts in total sea star abundance across 11 species. We specifically assessed whether this community responded to the sea star wasting disease (SSWD) epizootic, which began in 2013. We sampled at depths of 10, 25, 50 and 70 m near Port Madison, WA, and obtained long-term water temperature data. To account for species-level differences in SSWD susceptibility, we divided our sea star abundance data into two categories, depending on the extent to which the species is susceptible to SSWD, then conducted parallel analyses for high-susceptibility and moderate-susceptibility species. The abundance of high-susceptibility sea stars declined in 2014 across depths. In contrast, the abundance of moderate-susceptibility species trended downward throughout the years at the deepest depths- 50 and 70 m-and suddenly declined in 2006 across depths. Water temperature was positively correlated with the abundance of moderate-susceptibility species, and uncorrelated with high-susceptibility sea star abundance. The reported emergence of SSWD in Washington State in the summer of 2014 provides a plausible explanation for the subsequent decline in abundance of high-susceptibility species. However, no long-term stressors or mortality events affecting sea stars were reported in Washington State prior to these years, leaving the declines we observed in moderate-susceptibility species preceding the 2013-2015 SSWD epizootic unexplained. These results suggest that the subtidal sea star community in Port Madison is dynamic, and emphasizes the value of long-term datasets for evaluating patterns of change.


Assuntos
Ecossistema , Síndrome de Emaciação , Animais , Estrelas-do-Mar , Washington , Caquexia
15.
BMC Pediatr ; 23(1): 269, 2023 05 29.
Artigo em Inglês | MEDLINE | ID: mdl-37246212

RESUMO

BACKGROUND: Malnutrition in childhood has lasting consequences; its effects not only last a lifetime but are also passed down from generation to generation such as short stature, school-aged children are the most vulnerable section of the population and require special attention, including nutrition. METHOD: We searched Medline through PubMed, Scopus, and Web of Science to identify all observational studies published before Jun 2022. Observational studies with a pediatric population aged 5-18 years that evaluated risk estimate with 95% confidence intervals the relationship between dietary diversity and undernutrition (wasting, stunting, and thinness) were included. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) were followed. RESULTS: This is a first systematic review and meta-analysis with a total of 20 studies were eligible (n = 18 388). Fourteen data evaluated stunting resulting in a pooled effect size estimated odds ratio of 1.43 (95% CI: 1.08-1.89; p = 0.013). Ten data evaluated Thinness resulting in a pooled effect size estimated odds ratio of 1.10 (95% CI: 0.81-1.49; P = 0.542). Two studies were revealed wasting with a odds ratio of 2.18 (95% CI: 1.41-3.36; p-value < 0.001). CONCLUSION: According to the conclusions of this meta-analysis of cross-sectional studies, inadequate dietary diversity increases the risk of undernutrition in growth linear but not in thinness in school-aged children. The findings of this analysis suggest that initiatives that support improvements to the diversity of children's diets to reduce the risk of undernutrition may be warranted in LMICs.


Assuntos
Desnutrição , Síndrome de Emaciação , Criança , Humanos , Magreza/epidemiologia , Estudos Transversais , Síndrome de Emaciação/epidemiologia , Dieta , Desnutrição/epidemiologia , Transtornos do Crescimento/epidemiologia , Prevalência
16.
JCI Insight ; 8(8)2023 04 24.
Artigo em Inglês | MEDLINE | ID: mdl-37092555

RESUMO

Cancer cachexia (CC), a wasting syndrome of muscle and adipose tissue resulting in weight loss, is observed in 50% of patients with solid tumors. Management of CC is limited by the absence of biomarkers and knowledge of molecules that drive its phenotype. To identify such molecules, we injected 54 human non-small cell lung cancer (NSCLC) lines into immunodeficient mice, 17 of which produced an unambiguous phenotype of cachexia or non-cachexia. Whole-exome sequencing revealed that 8 of 10 cachexia lines, but none of the non-cachexia lines, possessed mutations in serine/threonine kinase 11 (STK11/LKB1), a regulator of nutrient sensor AMPK. Silencing of STK11/LKB1 in human NSCLC and murine colorectal carcinoma lines conferred a cachexia phenotype after cell transplantation into immunodeficient (human NSCLC) and immunocompetent (murine colorectal carcinoma) models. This host wasting was associated with an alteration in the immune cell repertoire of the tumor microenvironments that led to increases in local mRNA expression and serum levels of CC-associated cytokines. Mutational analysis of circulating tumor DNA from patients with NSCLC identified 89% concordance between STK11/LKB1 mutations and weight loss at cancer diagnosis. The current data provide evidence that tumor STK11/LKB1 loss of function is a driver of CC, simultaneously serving as a genetic biomarker for this wasting syndrome.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Colorretais , Neoplasias Pulmonares , Síndrome de Emaciação , Animais , Humanos , Camundongos , Quinases Proteína-Quinases Ativadas por AMP , Carcinoma Pulmonar de Células não Pequenas/complicações , Carcinoma Pulmonar de Células não Pequenas/genética , Carcinoma Pulmonar de Células não Pequenas/patologia , Neoplasias Colorretais/genética , Neoplasias Pulmonares/patologia , Mutação , Proteínas Serina-Treonina Quinases/metabolismo , Microambiente Tumoral , Redução de Peso
17.
Syst Rev ; 12(1): 46, 2023 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-36922839

RESUMO

BACKGROUND: Undernutrition is defined as not consuming enough nutrients and energy to meet one's needs for maintaining good health. It is exacerbated by armed conflict. Individuals cannot stick to jobs because of a lack of safety during conflicts, which has an impact on families' ability to purchase food. However, there is a paucity of evidence on pooled evidence on the impact of armed conflict on childhood undernutrition among children aged 6 to 59 months in Africa. Therefore, this review aimed to examine the effects of armed conflict on the magnitude of undernutrition, particularly stunting, underweight, and wasting among children in Africa. METHODS: A comprehensive literature search was conducted using electronic databases (PubMed, Hinari, and Google Scholar database) to locate potential studies. Heterogeneity between studies was checked using Cochrane Q test statistics and I2 test statistics. Small-study effects were checked using Egger's statistical test at a 5% significance level. A random-effects model was employed to estimate the pooled prevalence and associated factors of undernutrition among children aged 6-59 months in Africa. RESULTS: Of a total of 585 articles retrieved from the databases, 12 studies met our inclusion criteria. The pooled prevalence of wasting, stunting, and being underweight among conflict-affected African countries was 20.25% (95%CI = 15.08-25.43), 34.18% (95% CI = 26.34-42.02), and 24.00% (95%CI = 16.35-31.65), respectively. The most consistent factors associated with childhood stunting, wasting, and being underweight in Africa were low mother's education, prolonged duration of armed conflict, and rural place of residence. CONCLUSION: The severity of malnutrition crises will be assisted by a better understanding of the variables associated with child malnutrition, which will improve the effectiveness of development and humanitarian responses. We urge that health planners, policymakers, and the general public prioritize children with acute malnutrition in Africa's conflict-affected areas. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42022367487.


Assuntos
Desnutrição , Síndrome de Emaciação , Criança , Humanos , Magreza/epidemiologia , Magreza/etiologia , Síndrome de Emaciação/epidemiologia , Síndrome de Emaciação/complicações , Desnutrição/epidemiologia , Transtornos do Crescimento/epidemiologia , Transtornos do Crescimento/complicações , África/epidemiologia , Conflitos Armados , Prevalência
18.
JMIR Public Health Surveill ; 9: e39744, 2023 02 08.
Artigo em Inglês | MEDLINE | ID: mdl-36753309

RESUMO

BACKGROUND: Wasting is an immediate, visible, and life-threatening form of undernutrition in children aged <5 years. Within a short time, wasting causes recurrent sickness, delayed physical and mental growth, impatience, poor feeding, and low body weight. The long-term consequences of wasting and undernutrition are stunting, inability to learn, poor health status, and poor work performance. Wasting remains a public health problem in Ethiopia. According to the World Health Organization, countries have to reduce undernutrition including child wasting to below 5% by 2025. Ethiopia is attempting to attain national and international targets of undernutrition while struggling with many problems. OBJECTIVE: This study aimed to identify the prevalence and associated factors of wasting to provide information for further renewing policy commitments. METHODS: We used community-based, cross-sectional data from the Ethiopian Mini Demographic and Health Survey. The survey was conducted in 9 regions and 2 city administrations. Two-stage cluster sampling was used to recruit study participants. In the first stage, enumerations areas were selected, and 28-35 households per enumeration area were selected in the second stage. Our analysis included 2016 women with children aged <5 years from the 2019 EMDHS data set. We dropped incomplete records and included all women who fulfilled the eligibility criteria. We used multilevel ordinal regression using Generalized Linear Latent and Mixed Models (GLLAMM) and predicted probability with log-likelihood ratio tests. Fulfilling the proportional odds model's assumption during the application of multilevel ordinary logistic regression was a cumbersome task. GLLAMM enabled us to perform the multilevel proportional odds model using an alternative method. RESULTS: In our analysis, wasting was 7.68% (95% CI 6.56%-8.93%). Around 26.82% of mothers never used antenatal care for their current child. Most mothers (52.2%) did not have formal education, and 86.8% did not have postnatal care for their children. Additionally, half (50.93%) of the mothers have ≥6 household members. Wasting was associated with feeding diverse foods (coefficient 4.90, 95% CI 4.90-4.98), female sex of the household head (-40.40, 95% CI -40.41 to -40.32), home delivery (-35.51, 95% CI -35.55 to -35.47), first (16.66, 95% CI, 16.60-16.72) and second (16.65, 95% CI 16.60-16.70) birth order, female child (-12.65, 95% CI -12.69 to -12.62), and household size of 1 to 3 (10.86, 95% CI 10.80-10.92). CONCLUSIONS: According to the target set by World Health Organization for reducing undernutrition in children aged <5 years to below 5% by 2025, child wasting of 7.68% in Ethiopia should spark an immediate reaction from the government and stakeholders. Informed policy decisions, technology-based child-feeding education, and food self-sufficiency support could improve the current challenges. Additional effort is important to improve low maternal education, family planning, awareness of sex preferences, women empowerment, and maternal health services.


Assuntos
Desnutrição , Síndrome de Emaciação , Gravidez , Humanos , Feminino , Estudos Transversais , Etiópia/epidemiologia , Síndrome de Emaciação/epidemiologia , Síndrome de Emaciação/etiologia , Desnutrição/complicações , Desnutrição/epidemiologia , Características da Família
19.
Cells ; 12(4)2023 02 17.
Artigo em Inglês | MEDLINE | ID: mdl-36831310

RESUMO

Mobility is an intrinsic feature of the animal kingdom that stimulates evolutionary processes and determines the biological success of animals. Skeletal muscle is the primary driver of voluntary movements. Besides, skeletal muscles have an immense impact on regulating glucose, amino acid, and lipid homeostasis. Muscle atrophy/wasting conditions are accompanied by a drastic effect on muscle function and disrupt steady-state muscle physiology. Cachexia is a complex multifactorial muscle wasting syndrome characterized by extreme loss of skeletal muscle mass, resulting in a dramatic decrease in life quality and reported mortality in more than 30% of patients with advanced cancers. The lack of directed treatments to prevent or relieve muscle loss indicates our inadequate knowledge of molecular mechanisms involved in muscle cell organization and the molecular etiology of cancer-induced cachexia (CIC). This review highlights the latest knowledge of regulatory mechanisms involved in maintaining muscle function and their deregulation in wasting syndromes, particularly in cachexia. Recently, protein posttranslational modification by the small ubiquitin-like modifier (SUMO) has emerged as a key regulatory mechanism of protein function with implications for different aspects of cell physiology and diseases. We also review an atypical association of SUMO-mediated pathways in this context and deliberate on potential treatment strategies to alleviate muscle atrophy.


Assuntos
Doenças Musculares , Neoplasias , Síndrome de Emaciação , Animais , Caquexia/etiologia , Ubiquitina/metabolismo , Músculo Esquelético/metabolismo , Atrofia Muscular/patologia , Síndrome de Emaciação/metabolismo , Doenças Musculares/patologia , Neoplasias/metabolismo , Homeostase
20.
J Nutr Sci ; 12: e25, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36843979

RESUMO

The combined burden of stunting and wasting in children under five years is a serious public health concern. The present study aimed to estimate the joint burden of stunting and wasting among children aged 6-59 months and explore its spatial variation across Nepal. The 2016 Nepal Demographic and Health Survey data was used to study acute and chronic childhood malnutrition. A Bayesian distributional bivariate probit geoadditive model was designed to study the linear association and geographical variation of stunting and wasting among 6-59 months, children. Child-related factors such as low birth weight, fever in the last 2 weeks preceding the survey and fourth or greater birth order were associated with a higher likelihood of stunting. The likelihood of a child being stunted was significantly less in the wealthiest households, having improved toilet facilities, and if mothers were overweight. Children from severely food insecure households were significantly more likely, and children from poorer households were significantly less likely to suffer both acute and chronic malnutrition simultaneously. Results from spatial effect showed that children from Lumbini and Karnali had a higher burden of stunting, and the likelihood that achild would have been wasted was significantly higher in Madhesh and Province 1. Immediate nutritional efforts are vital in low-income and severely food insecure households to lessen the risk of stunting and wasting in under children. Disproportionate geographic variations in stunting and wasting warrant sub-regional-specific nutrition intervention to achieve nutrition targets and reduce the burden of childhood malnutrition across the country.


Assuntos
Desnutrição , Síndrome de Emaciação , Feminino , Humanos , Pré-Escolar , Nepal/epidemiologia , Teorema de Bayes , Síndrome de Emaciação/epidemiologia , Desnutrição/epidemiologia , Transtornos do Crescimento/epidemiologia
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