RESUMO
Background: Malnutrition has important short- and long-term consequences in children under age five. Malnutrition encompasses undernutrition, overnutrition, and the coexistence of both of them, known as the double burden of malnutrition (DBM). Objective: The aim of this study was to estimate the prevalence of undernutrition, overnutrition, and the DBM among these children at the national level and by living area in Panama. Methods: Data from the National Health Survey of Panama (ENSPA, Spanish acronym), a population-based, cross-sectional study carried out in 2019 were used. Stunting, wasting, overweight, and obesity were defined according to the cut-off points of the World Health Organization Growth Standards. Undernutrition was defined as being stunted only, wasted only or both; overnutrition was defined as being overweight only or obese only; and the DBM was defined as the co-occurence of stunting and overweight/obesity in the same child. Prevalence and general characteristics at the national level and by living area were weighted. Findings: The prevalence of undernutrition was 15.3% (95% confidence interval (CI) 13.4-17.3) at the national level and 36.6% (CI: 30.1-43.5) in indigenous areas. The prevalence of overnutrition was 10.2% (8.2-12.6) at the national level and 11.9% (CI: 8.5-16.3), 8.4% (CI: 6.5-10.7) and 8.7% (CI: 5.2-14.3) in urban, rural and indigenous areas, respectively. The DBM prevalence was 1.4% (CI: 1.0-2.1) at the national level and 2.7% (CI: 1.4-5.1) in indigenous areas. Conclusions: Undernutrition is still the most prevalent malnutrition condition in our country. Panama has the highest prevalence of overnutrition in Central America. The highest prevalence of undernutrition and DBM was found among children living in indigenous areas.
Assuntos
Transtornos do Crescimento , Desnutrição , Humanos , Panamá/epidemiologia , Pré-Escolar , Feminino , Masculino , Prevalência , Lactente , Estudos Transversais , Transtornos do Crescimento/epidemiologia , Desnutrição/epidemiologia , Transtornos da Nutrição Infantil/epidemiologia , Hipernutrição/epidemiologia , Síndrome de Emaciação/epidemiologia , Inquéritos Epidemiológicos , Obesidade Infantil/epidemiologia , Sobrepeso/epidemiologia , População Rural/estatística & dados numéricosRESUMO
Introduction: child malnutrition is one of the most serious and least addressed health problems in the world and in Ethiopia. The prevalence of malnutrition, underweight, and wasting was 44%, 29%, and 10% respectively. The Amhara region has the highest rates of malnutrition at 52%, 33.4%, and 9.9% for children under five. The aim of this study was to assess the prevalence of malnutrition and its associated factors among children under five living in the slum areas of Bahir Dar City. Methods: a community-based cross-sectional study was conducted with 680 children aged 6-59 months in slum areas of Bahir Dar Town. Study participants were selected using a mass sampling technique and data were collected from April to June 2018 using a pre-tested structured questionnaire and anthropometric measurements. Finally, the collected data were coded, entered, cleaned, recorded, and stored, and the data were processed using EPI INFO and exported to the SPSS version 25.0 statistical package. Logistic regression analysis and interpretation were performed using bivariate and multivariate analysis. Results: a total of 680 children participated. The prevalence of stunting, underweight, and wasting was 46.2% (95% CI; 42.5-49.1), 24.3% (95% CI; 21.2-27.6), and 11.3% (95% CI; CI; 9.2-13.9). Income groups included children [AOR=3.476 (95% CI, 1.959-6.167)], male children [AOR=2.586 (95% CI; 1.532-4.365)] and mother's educational level [(AOR=2.600) (1.623) - 4.164)] were significantly associated with malnutrition. Conclusion: the results of this study showed that the prevalence of malnutrition due to stunting and wasting was high among children under five years of age. The gender of the child, the educational level of the mother, and the monthly income of the family were found to be significantly related to malnutrition. Promoting the use of family planning, preventing diarrheal diseases, and vaccinating children through nutrition education programs are important activities to improve the nutritional status of children.
Assuntos
Transtornos da Nutrição Infantil , Transtornos do Crescimento , Áreas de Pobreza , Magreza , Síndrome de Emaciação , Humanos , Etiópia/epidemiologia , Masculino , Feminino , Prevalência , Estudos Transversais , Lactente , Pré-Escolar , Transtornos da Nutrição Infantil/epidemiologia , Magreza/epidemiologia , Transtornos do Crescimento/epidemiologia , Síndrome de Emaciação/epidemiologia , Inquéritos e Questionários , Fatores de Risco , EscolaridadeRESUMO
Despite a remarkable reduction in global poverty and famines, substantial childhood malnutrition continues to persist. In 2017, over 50 million and 150 million young children suffered from acute malnutrition (wasting) and chronic malnutrition (stunting), respectively. Yet, the measurable impact of determinants is obscure. We evaluate proposed socio-environmental related determinants of stunting and wasting across Kenya and Nigeria and quantify their effectiveness. We combine health and demographic data from Kenya and Nigeria Demographic Health Surveys (2003, 2008-2009, 2013, 2014) with spatially explicit precipitation, temperature, and vegetation data. Geospatial and disaggregated data help to understand better who is at risk and where to target mitigation efforts. We evaluate the responsiveness of malnutrition indicators using a four-level random intercept hierarchical generalized logit model. We find that spatial and hierarchical relationships explain 28% to 36% of malnutrition outcome variation. Temporal variation in precipitation, temperature, and vegetation corresponds with more than a 50% change in malnutrition rates. Wasting is most impacted by mother's education, family wealth, clinical delivery, and vaccinations. Stunting is most impacted by family wealth, mother's education, clinical delivery, vaccinations, and children asymptomatic of fever, cough, or diarrhea. Remotely monitored climatic variables are powerful determinants, however, their effects are inconsistent across different indicators and locations.
Assuntos
Transtornos da Nutrição Infantil , Transtornos do Crescimento , Fatores Socioeconômicos , Humanos , Pré-Escolar , Lactente , Transtornos do Crescimento/epidemiologia , Transtornos do Crescimento/etiologia , Transtornos da Nutrição Infantil/epidemiologia , Feminino , Quênia/epidemiologia , Nigéria/epidemiologia , Masculino , Fatores de Risco , Síndrome de Emaciação/epidemiologia , Análise Espacial , Determinantes Sociais da Saúde , Inquéritos EpidemiológicosRESUMO
Background: Adolescent motherhood and malnutrition among children are significant challenges in Africa, but there is limited data on the impact of adolescent motherhood on their children's health and nutrition. This study assessed infant feeding practices, prevalence of adolescent motherhood, and malnutrition among infants in Mangu local government area (LGA). Methodology: A cross-sectional survey using multistage sampling was conducted. Validated questionnaires were used to collect socio-demographic data, and appropriate tools were used for anthropometric measurements. Data were compared with established standards. Descriptive statistical tools, chi square, Pearson correlation, and independent sample t-test were used for data analysis, with significance set at p < 0.05. Results: A total of 200 mothers completed the study. The majority of the infants (78.5%) were less than 6 months old, and 21.5% were 6-12 months old. Breastfeeding initiation within 1 hour was reported by 39% of mothers, while 38% practiced prelacteal feeding. Only 28.5% practiced exclusive breastfeeding, and all mothers breastfed their babies. The prevalence of adolescent motherhood was 37.5%. The prevalence of stunting, wasting, and underweight among infants were 29.5%, 12%, and 8.5%, respectively. Children of adolescent mothers had higher rates of severe stunting compared to children of mothers above 19 years of age. There were significant differences (p = 0.017 and p = 0.029) in stunting rates and weight-for-age indices between children of adolescent mothers and mothers above 19 years of age. Conclusion: Adolescent motherhood contributes to chronic malnutrition in children, and there is a high prevalence of malnutrition among infants in Mangu LGA, Plateau State.
Assuntos
Aleitamento Materno , Magreza , Humanos , Lactente , Adolescente , Feminino , Nigéria/epidemiologia , Estudos Transversais , Aleitamento Materno/estatística & dados numéricos , Prevalência , Magreza/epidemiologia , Adulto Jovem , Masculino , Gravidez na Adolescência/estatística & dados numéricos , Transtornos do Crescimento/epidemiologia , Adulto , Síndrome de Emaciação/epidemiologia , Mães , Transtornos da Nutrição do Lactente/epidemiologia , Desnutrição/epidemiologia , Recém-Nascido , Governo Local , Gravidez , Inquéritos e QuestionáriosRESUMO
Wasting marmoset syndrome (WMS), a serious disease in captive common marmoset (Callithrix jacchus) colonies, is associated with a high mortality rate. The specific cause of WMS is still unclear and there are few effective treatments. Previously, we had reported a tranexamic acid therapy with supportive measures as a useful treatment for WMS. In the present study, we describe the modified method: a combination of 0.1 mL of 5% tranexamic acid subcutaneously five times per week, 2.0 mL of amino acid formulation intravenously three times per week, 5.0 mL of Ringer's lactate with 0.1 mL of a vitamin formulation subcutaneously three times per week, and oral administration of 0.1 mL of an iron formulation five times per week. We also describe how to administer the solution intravenously via the saphenous vein with a tip of restraining the animal, as well as the detailed methods for oral and subcutaneous administration. The modified methods have comparable efficiency to the original WMS treatment method.
Assuntos
Antifibrinolíticos , Callithrix , Ácido Tranexâmico , Animais , Ácido Tranexâmico/administração & dosagem , Antifibrinolíticos/administração & dosagem , Síndrome de Emaciação/tratamento farmacológico , Administração OralRESUMO
The current study aimed to find the risk factors of wasting in flood-affected areas of Khyber Pakhtunkhwa, Pakistan. Sociodemographic and anthropometric data was collected. Children living in large family are 2.59 times more likely to be wasted (AOR = 2.59, 95% confidence interval (CI): 1.10, 6.10; p value = .029) and children living in medium size family are 2.23 times more likely to be wasted (AOR = 2.23, 95% CI: 1.03, 4.80; p value = .04) as compared to children in small family size. The study underscores the need for targeted interventions to address the identified risk factors and mitigate the impact of flooding on child nutrition.
Assuntos
Inundações , Síndrome de Emaciação , Humanos , Paquistão/epidemiologia , Estudos Transversais , Fatores de Risco , Feminino , Masculino , Pré-Escolar , Síndrome de Emaciação/epidemiologia , Transtornos da Nutrição Infantil/epidemiologia , Lactente , Características da Família , Criança , Desnutrição/epidemiologia , Fatores SocioeconômicosRESUMO
BACKGROUND: The burden of wasting among under five children in India, has not reduced in the last decade. OBJECTIVES: We used child-level data from the latest nationally representative Comprehensive National Nutritional Survey (CNNS) to estimate the prevalence of wasting at the national and state level in India. METHODS: We explored the association of wasting with maternal, child and household factors using multivariable logistic regression for the age group of 0-5, 6-23 and 24-59 months. RESULTS: The overall prevalence of wasting was 17.3%, ranging from 5.8% to 29.1% across states, 23.3% in children 0-5 months, 19.6 % in children 6-23 months and 15.4 % in children 24-59 months of age. Higher birthweight i.e., every 100g increase (0-5 months aOR = 0.96, 6-23 months aOR = 0.94, 24-59 months aOR = 0.96), higher maternal BMI (0-5 months aOR = 0.51, 6-23 months aOR = 0.62, 24-59 months aOR = 0.67), increasing child age in months (0-5 months aOR = 0.84) and female sex of the child (24-59 months aOR = 0.82) was found to have significantly lower odds of wasting. The odds of wasting were significantly higher for poorest wealth quintile (0-5 months aOR = 1.99, 6-23 months aOR = 2.13), maternal unemployment (0-5 months aOR = 2.25), and lower levels of maternal education (6-23 months aOR = 1.74). CONCLUSIONS: Our analyses showed that burden of wasting continues to remain high in India. Preventive interventions must target reduction of low birthweight. Early identification and management of wasting should be done, especially during the first six months of life who are not part of current therapeutic feeding programme.
Assuntos
Inquéritos Nutricionais , Fatores Socioeconômicos , Síndrome de Emaciação , Humanos , Índia/epidemiologia , Lactente , Prevalência , Feminino , Masculino , Pré-Escolar , Síndrome de Emaciação/epidemiologia , Recém-Nascido , Fatores de Risco , Peso ao Nascer , Fatores Sexuais , Fatores Etários , Fatores SociodemográficosRESUMO
BACKGROUND: Street children are poverty-stricken and have insufficient money to meet their daily nutritional requirements. They do not have a proper place to sleep and defecate. They sleep at traffic signals, in religious places, and on footpaths. This exposes them to pollution, dirt, and other pathogens. OBJECTIVES: This study aimed to measure the nutritional status of street children in Delhi using Z-scores and Composite Index of Anthropometric Failure (CIAF). METHODS: Anthropometric measurements are direct methods of measuring the nutritional status of humans. Anthropometric indicators such as underweight (weight-for-age), stunting (height-for-age) and BMI/wasting (weight-for-height) are used to measure the nutritional status of street children. Z-scores and CIAF are calculated for street children based on the WHO 2009 reference. RESULTS: According to Z-scores, stunting (56%) is the most common anthropometric failure among street children followed by underweight (31%) and wasting (19%). According to the CIAF, 63% of street children are malnourished, where stunting (37%) is the highest single burden of anthropometric failure, followed by wasting (3%) and underweight (1%); children suffering from the double burden of anthropometric failure are 9%, and children suffering from the triple burden of anthropometric failure (i.e., wasting, stunting, and underweight) are 13%. CONCLUSION: A high incidence of stunting points to poor quality of food and suggests prolonged nutrition deficiency among street children. The Z-score or conventional measures of anthropometry underestimate the total burden of malnutrition among street children, while CIAF provides an estimation of children with single-burden, double-burden, and triple-burden malnutrition or total burden of malnutrition.
Assuntos
Antropometria , Transtornos do Crescimento , Desnutrição , Estado Nutricional , Magreza , Humanos , Índia/epidemiologia , Masculino , Feminino , Antropometria/métodos , Criança , Magreza/epidemiologia , Transtornos do Crescimento/epidemiologia , Transtornos do Crescimento/etiologia , Desnutrição/epidemiologia , Desnutrição/diagnóstico , Pré-Escolar , Jovens em Situação de Rua/estatística & dados numéricos , Estudos Transversais , Síndrome de Emaciação/epidemiologia , Estatura , Adolescente , Peso Corporal , Índice de Massa Corporal , Transtornos da Nutrição Infantil/epidemiologia , Transtornos da Nutrição Infantil/diagnóstico , Pobreza/estatística & dados numéricos , Lactente , PrevalênciaRESUMO
The aim was to assess maternal feeding practices of children one to three years. A descriptive observational design was employed. The sample consisted of mothers-child dyads. A validated structured questionnaire was used. Data was analyzed using SPSS version 26.0. The nutrition status of the children at birth indicated 11.6% underweight as compared to the time of the study (7.2%), 7.9% were stunted increased to 38.0%, while wasting decreased from 11.4%-2.4%. Early cessation of breastfeeding and inappropriate complementary feeding practices were the factors influencing growth. The prevalence of underweight and wasting were low while stunting and overweight were high.
Assuntos
Aleitamento Materno , Fenômenos Fisiológicos da Nutrição do Lactente , Mães , Estado Nutricional , Magreza , Humanos , Feminino , África do Sul/epidemiologia , Pré-Escolar , Lactente , Masculino , Magreza/epidemiologia , Adulto , Transtornos do Crescimento/epidemiologia , Sobrepeso/epidemiologia , Inquéritos e Questionários , Comportamento Alimentar , Prevalência , Síndrome de Emaciação/epidemiologiaRESUMO
Cancer cachexia-associated muscle wasting as a multifactorial wasting syndrome, is an important factor affecting the long-term survival rate of tumor patients. Photobiomodulation therapy (PBMT) has emerged as a promising tool to cure and prevent many diseases. However, the effect of PBMT on skeletal muscle atrophy during cancer progression has not been fully demonstrated yet. Here, we found PBMT alleviated the atrophy of myotube diameter induced by cancer cells in vitro, and prevented cancer-associated muscle atrophy in mice bearing tumor. Mechanistically, the alleviation of muscle wasting by PBMT was found to be involved in inhibiting E3 ubiquitin ligases MAFbx and MuRF-1. In addition, transcriptomic analysis using RNA-seq and GSEA revealed that PI3K/AKT pathway might be involved in PBMT-prevented muscle cachexia. Next, we showed the protective effect of PBMT against muscle cachexia was totally blocked by AKT inhibitor in vitro and in vivo. Moreover, PBMT-activated AKT promoted FoxO3a phosphorylation and thus inhibiting the nucleus entry of FoxO3a. Lastly, in cisplatin-treated muscle cachexia model, PBMT had also been shown to ameliorate muscle atrophy through enhancing PI3K/AKT pathway to suppress MAFbx and MuRF-1 expression. These novel findings revealed that PBMT could be a promising therapeutic approach in treating muscle cachexia induced by cancer.
Assuntos
Caquexia , Proteína Forkhead Box O3 , Doenças Musculares , Neoplasias , Fosfatidilinositol 3-Quinases , Proteínas Proto-Oncogênicas c-akt , Síndrome de Emaciação , Caquexia/etiologia , Caquexia/metabolismo , Caquexia/terapia , Doenças Musculares/etiologia , Doenças Musculares/metabolismo , Doenças Musculares/terapia , Neoplasias/complicações , Redes e Vias Metabólicas , Fosfatidilinositol 3-Quinases/genética , Fosfatidilinositol 3-Quinases/metabolismo , Proteínas Proto-Oncogênicas c-akt/genética , Proteínas Proto-Oncogênicas c-akt/metabolismo , Proteína Forkhead Box O3/genética , Proteína Forkhead Box O3/metabolismo , Síndrome de Emaciação/etiologia , Síndrome de Emaciação/metabolismo , Síndrome de Emaciação/terapia , Animais , Modelos Animais de Doenças , Camundongos , Linhagem Celular , Masculino , Camundongos Endogâmicos BALB C , Perfilação da Expressão GênicaRESUMO
OBJECTIVE: Most evidence supporting screening for undernutrition is for children aged 6-59 months. However, the highest risk of mortality and highest incidence of wasting occurs in the first 6 months of life. We evaluated relationships between neonatal anthropometric indicators, including birth weight, weight-for-age Z-score (WAZ), weight-for-length Z-score (WLZ), length-for-age Z-score (LAZ) and mid-upper arm circumference (MUAC) and mortality and growth at 6 months of age among infants in Burkina Faso. DESIGN: Data arose from a randomised controlled trial evaluating neonatal azithromycin administration for the prevention of child mortality. We evaluated relationships between baseline anthropometric measures and mortality, wasting (WLZ < -2), stunting (LAZ < -2) and underweight (WAZ < -2) at 6 months of age were estimated using logistic regression models adjusted for the child's age and sex. SETTING: Five regions of Burkina Faso. PARTICIPANTS: Infants aged 8-27 d followed until 6 months of age. RESULTS: Of 21 832 infants enrolled in the trial, 7·9 % were low birth weight (<2500 g), 13·3 % were wasted, 7·7 % were stunted and 7·4 % were underweight at enrolment. All anthropometric deficits were associated with mortality by 6 months of age, with WAZ the strongest predictor (WAZ < -2 to ≥ -3 at enrolment v. WAZ ≥ -2: adjusted OR, 3·91, 95 % CI, 2·21, 6·56). Low WAZ was also associated with wasting, stunting, and underweight at 6 months. CONCLUSIONS: Interventions for identifying infants at highest risk of mortality and growth failure should consider WAZ as part of their screening protocol.
Assuntos
Antropometria , Peso ao Nascer , Transtornos do Crescimento , Mortalidade Infantil , Magreza , Humanos , Burkina Faso/epidemiologia , Lactente , Masculino , Feminino , Recém-Nascido , Transtornos do Crescimento/epidemiologia , Transtornos do Crescimento/mortalidade , Magreza/epidemiologia , Magreza/mortalidade , Estatura , Recém-Nascido de Baixo Peso , Azitromicina/administração & dosagem , Azitromicina/uso terapêutico , Desenvolvimento Infantil , Síndrome de Emaciação/epidemiologia , Síndrome de Emaciação/mortalidade , Peso Corporal , Modelos LogísticosRESUMO
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 EpidemiológicosRESUMO
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 RetrospectivosRESUMO
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/etiologiaRESUMO
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/fisiologiaRESUMO
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 NascerRESUMO
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 RenalRESUMO
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.