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At least 757 records · Page 42Linked to original sources

The burden of pneumonia in children: an Asian perspective.

Pneumonia results in two million deaths each year among children worldwide (20% of all child deaths), 70% of them in Africa and South-east Asia. Most countries in Africa and Asia record 2-10 times more children with pneumonia (7-40/100 annually) than in the USA. Apart from resource constraints and an overburdened health system, there is lack of uniformity in defining pneumonia. Most nations employ a WHO standard case management protocol using age-specific cut-offs for increased respiratory rates and chest in-drawing for a clinical definition of pneumonia. The limited data available on the causative organisms have identified Streptococcus pneumoniae, Haemophilus influenzae and viruses such as respiratory syncytial virus (RSV), influenza, para influenza and adenoviruses as the major pathogens. Measles infection increases pneumonia morbidity and mortality. Low birth weight, under-nutrition, hypovitaminosis A, zinc deficiency, lack of breastfeeding, air pollution (including environmental tobacco smoke) and over-crowding increase the risk for pneumonias in children. Standard case management protocols used for acute respiratory infections (ARIs) in these countries have brought down the disease burden but an improvement in the diagnostic algorithm is needed to appropriately recognise those with associated wheeze. Research is needed to find effective and affordable preventive strategies.

Air Pollution↗

Reversible neurologic dysfunction caused by severe vitamin deficiency after malabsorptive bariatric surgery.

Significant deficiencies of both fat- and water-soluble vitamins have been reported to occur after malabsorptive bariatric surgery. However, despite the potential for neurologic manifestations of such deficiencies, few cases of central neurologic dysfunction have been reported. Our group previously reported reversible neurologic dysfunction as an unusual manifestation of vitamin deficiency in a postjejunoileostomy patient. We report on a second case of reversible neurologic dysfunction associated with severe, prolonged vitamin deficiency many years after jejunoileostomy. Neurologic function returned to normal with vitamin repletion. Patients who have undergone malabsorptive surgery are at risk of late metabolic complications and should be closely monitored.

Avitaminosis↗

Vitamins deficiency in developing chick during chromium intoxication and protection thereof.

Deficiency of various vitamins in postnatally developing chick during chromium intoxication and their recovery during vitamins (B and E) and glutathione therapies has been investigated. Study was concentrated on liver, kidney, muscles and serum. Newly hatched chicks were reared in laboratory. They were treated with a daily dose of 10mg/kg/day potassium dichromate from 2nd to 8th day of their age. Thereafter, one group was sacrificed on 9th day. Second group was kept without intoxication for another 7 days and sacrificed on 16th day. Three groups of chromium pretoxicated animals were exposed to therapeutic agents like vitamins (B and E) and glutathione for another 7 days. These animals were sacrificed on 16th day of their age along with control. Study showed chromium intoxication decreases vitamins (B(1), B(2), B(6) and E) in all the tissues and serum. The maximum decrease was recorded in serum. The 7 days pretoxicated animals kept without any treatment for 7 days revealed a slow increase of vitamins with few exceptions. Nevertheless, the recovery of vitamins was quick and significant during vitamins and glutathione therapy and in some cases control level was achieved.

Alanine Transaminase↗

Micronutrient malnutrition and the pathogenesis of malarial anemia.

Malaria is a leading cause of morbidity and mortality worldwide, and anemia is a common and sometimes serious complication of Plasmodium falciparum infection. Although micronutrient malnutrition is usually highly prevalent in malaria endemic areas, the contribution of micronutrient deficiencies to malarial anemia is often overlooked. Recent investigation suggests that micronutrients such as vitamin A, vitamin E, and zinc, may improve the morbidity of malaria through immune modulation and alteration of oxidative stress. Micronutrients are also involved in the pathogenesis of anemia and likely play a role in malarial anemia, but many clinical trials have not specifically addressed the impact of micronutrient supplementation on malarial anemia. Further work is needed to assess the effect of both clinic and community-based micronutrient interventions on malarial anemia in infants, children, and pregnant women.

Adolescent↗

Nutrition management of patients with epidermolysis bullosa.

Epidermolysis bullosa (EB), a heterogeneous group of rare, inherited disorders, is manifested by recurrent blistering of the skin induced by the slightest trauma. Little information exists regarding the nutrition management of patients with EB. This study presents information on growth, identifies potential nutrition problems, and provides guidelines for nutrition management of persons with EB. Eighty patients attending a dermatology clinic for EB patients are described. Severity of disease ranged from mild blistering of the knees, elbows, and feet to extensive blistering and scarring of the skin and entire gastrointestinal tract. Of the 18 children with EB simplex, which is a mild form of the disease, 4 (22%) were at nutritional risk. None of the 13 adults with EB simplex were underweight and 8 (62%) were overweight. Of the patients with the more severe forms of EB, 27 of the 35 (77%) children with dystrophic EB and 4 of the 7 (57%) children with junctional EB were at risk for malnutrition. Of the 7 adults with dystrophic EB, 6 (86%) were underweight. Common nutrition problems included protein-energy malnutrition, chewing and swallowing problems, constipation, anemia, and vitamin/mineral deficiencies. When nutrition care protocols address these problems, growth, development, and nutritional status can improve. For those with severe nutrition problems, gastrostomy feeding or similar nutrition therapies should be considered.

Adolescent↗

Retinoic acid rapidly induces lung cellular retinol-binding protein mRNA levels in retinol deficient rats.

Retinol deficiency resulted in decreased mRNA levels for cellular retinol-binding protein (CRBP) in the lungs and the testes. The level of lung CRBP mRNA increased 2.3-fold one hour after oral administration of retinoic acid to retinol deficient rats. In contrast, testicular CRBP mRNA level was not influenced. Our data indicate that retinoic acid regulates CRBP mRNA level in the whole animal and this rapid effect suggests a role for CRBP in the mechanism of vitamin A action at genomic level.

Animals↗

Implications of nutritional status on human biochemistry, physiology, and health.

Optimum nutrition is the level of intake that should promote the highest level of health. Although excess caloric intake will lead to obesity, a deficit in nutrition may result in a tissue depletion of essential nutrients that can lead to biochemical changes and eventually to clinical signs and symptoms. Nutrition requirements may differ according to sex, age, activity, or physiological state and can be influenced by drugs, smoking, alcohol, and other factors. With ever-increasing sedentary life styles and less physically demanding jobs, the resulting reduced caloric requirements have made it more difficult to make nutritionally sound food choices. Nutrition is the single most important component of preventive health care. Diet has been associated with cancer, heart disease, diabetes, stroke and hypertension, arteriosclerosis, and cirrhosis of the liver. The ability of the human to respond to stresses, such as altitude, heat, trauma, surgery, and infection can be influenced by nutritional status. Nutritional status is reflected in a variety of metabolic processes that provide the basis for a number of methods for its assessment.

Alcoholism↗

Vitamin A and E status in very low birth weight infants: development of an improved parenteral delivery system.

Plasma vitamin A and E levels were inadequate in very low birth weight infants receiving a continuous infusion of a parenteral multivitamin preparation, 1.5 ml/kg per day, in dextrose-amino acid solution. A new delivery system using 2 ml/kg per day, infused for 6 hours from the first day of life, avoided loss during infusion and significantly improved plasma vitamin A and E levels during the first 28 days of life in very low birth weight infants.

Avitaminosis↗

Reversible dementias.

With so many conditions that can manifest in dementia, the question arises as to how extensive an evaluation need be done on the individual patient presenting with dementia. Thorough physical, neurologic, and psychiatric examinations are the cornerstones of the work-up, with special attention paid to the history, use of medications, and mental status of the patient. Laboratory tests recommended by the National Institutes of Health Consensus Conference on Differential Diagnosis of Dementing Diseases include a complete blood count, electrolyte and metabolic screen, thyroid panel, vitamin B12 and folate levels, syphilis serology, urinalysis, chest radiograph and electrocardiogram, and head CT scan. These evaluations are sufficient to diagnose the majority of treatable dementias. Other evaluations including magnetic resonance imaging, electroencephalography, cerebrospinal fluid examination, cerebral blood flow and metabolism measures (rate of cerebral blood flow, single photon emission computed tomography, and positron-emission tomography), and brain biopsy all can be of additional assistance in diagnosing the cause of the dementia when justified by the clinical setting. When the appropriate diagnosis is made, therapy is directed at the primary disorder. Successful treatment of the primary condition may result in stabilization or partial or complete reversal of the cognitive disturbance. In some instances, judicious pharmacologic management of the accompanying behavioral disturbance may be required.

Avitaminosis↗

Evaluation and management of nutritional status before surgery.

Preoperative evaluation of all patients should include evaluation of nutritional status. Factors of greatest clinical usefulness are nutritional history correlated with the clinical situation, and measures of body height and weight, serum albumin concentration, and muscle mass. Depressed immune function suggested by a lack of skin test reactivity to standard antigens may correlate with the risk of postoperative complications and death, but further studies are required to determine the specific relation of nutrient deficiencies and immune function. Micronutrient deficiencies must be identified and corrected rapidly. Nutritional support in patients with nutritional deficiencies should be started preoperatively either by enteral or intravenous techniques and continued postoperatively.

Anthropometry↗

Physical findings in nutritional deficiencies.

Manifestations of deficiencies of protein, calories, vitamins, and trace elements are described. These findings are placed in the context of the functions, food sources, and causes of deficiency of each micronutrient.

Avitaminosis↗

Metabolic complications of parenteral nutrition in infants and children.

Metabolic complications of TPN in infants and children are numerous and frequent. Properly designed nutrient solutions, careful monitoring, knowledge of potential problems, and appropriate management are essential to avoid serious complications. Hepatic dysfunction is most likely to prevent achievement of adequate nutrient intake. Better delineation of trace metal, essential fatty acid, and vitamin deficiencies is necessary, particularly in patients who require long-term TPN.

Acid-Base Imbalance↗

Laboratory assessment of nutritional status.

Malnutrition is one of the major causes of increased morbidity and mortality among hospitalized patients. The availability of nutritional therapy for these patients has made clinicians aware of the need for reliable methods of nutritional assessment. A variety of anthropometric, biochemical, and immunologic parameters has been used as indicators of protein-calorie malnutrition. Recently, the concentration of several rapid-turnover visceral proteins (transferrin, thyroxine-binding prealbumin and retinol-binding protein) has been shown to be a very sensitive parameter for indicating both the efficiency of nutritional therapy and conditions of borderline protein intake in apparently healthy children. Likewise, several immunologic parameters (including T cells, delayed hypersensitivity response, and complement components) have been shown to correlate with morbidity, mortality risk, sepsis, and death.

Avitaminosis↗