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At least 127 records · Page 7Linked to original sources
PubMed1995

Pharmacokinetics of amikacin in children with kwashiorkor.

The pharmacokinetics of intravenous amikacin, administered as a mean (SD) bolus dose of 5.5 (1.2) mg/kg to children between the ages of 1 and 4 years with kwashiorkor, was studied. Although there was a tendency for the average volume of distribution to increase to the upper limit of normal, plasma elimination half-life, first order elimination-phase rate constant and clearance remained close to the reference values for adults. Despite marginal elevation of the average t1/2 beta-value, reflecting a general trend, renal impairment in respect of amikacin clearance could not be demonstrated. It was concluded that the changes in pharmacokinetic parameters found in kwashiorkor are not large enough to amend the current therapeutic regimens for amikacin in this condition.

Amikacin↗
PubMed1977

Chloramphenicol binding to normal and kwashiorkor sera.

The binding of chloramphenicol to normal and kwashiorkor sera was investigated in vitro. Chloramphenicol is predominantly albumin bound, although a significant degree of binding to the other major protein fractions occurs. From the clinical view point, a decreased degree of binding of kwashiorkor serum (+/-5%) is not of significance.

Alpha-Globulins↗
PubMed1979

Penicillin pharmacokinetics in kwashiorkor.

Intravenous penicillin kinetics have been studied in eight children with kwashiorkor on admission to hospital and when rehabilitated. A 75% increase in penicillin clearance was observed with recovery, associated with a fall in half-life; this was probably due to an improvement of both renal plasma flow and tubular function. The present observations and those of other authors working in this area are discussed and an approach to drug dosage of renally excreted drugs in kwashiorkor has been proposed.

Half-Life↗
PubMed1979

Antipyrine pharmacokinetics and D-glucaric excretion in kwashiorkor.

Hepatic microsomal oxidation and glucuronidation were studied in 15 children with kwashiorkor on admission to the hospital and again after 3 weeks of nutritional rehabilitation. Microsomal oxidation as measured by antipyrine half-life and clearance was shown to be depressed in the acute phase of malnutrition (T 1/2 = 7.9 +/- 5.0 hr, clearance = 8.4 +/- 5.1 ml/min) improving with nutritional rehabilitation (T 1/2 = 4.3 +/- 2.3 hr, clearance = 15.5 +/- 8.7 ml/min). Urinary D-glucaric acid excretion increased from 60.6 +/- 42.2 mumoles/24 hr to 121.8 +/- 105.0 mumoles/24 hr over the same time period. Evidence is thus presented that both hepatic microsomal oxidation and glucuronidation are depressed in the acute phase of kwashiorkor but recover with nutritional rehabilitation.

Antipyrine↗
PubMed1979

Long-term effects of kwashiorkor on the electroencephalogram.

The long-term effects of kwashiorkor on the electroencephalogram were assessed by means of computer analysis techniques. The experimental group, consisting of 30 black children, 6 to 12 years old, hospitalized for the treatment of kwashiorkor during the first 27 months of life, was age-matched with three control groups. These were a group of siblings and of yardmates, neither of whom had been exposed to acute infantile malnutrition, and a very high socioeconomic group of white children. The results revealed significantly less alpha activity and more slow-wave activity in the electroencephalogram of the kwashiokor group than in those of the control groups. These findings confirmed previous results based on visual analysis procedures.

Alpha Rhythm↗
PubMed1979

Height, weight, and head circumference in survivors of marasmus and kwashiorkor.

The physical growth of 44 survivors of marasmus and 43 survivors of kwashiorker 7 1/2 years after their hospitalization and cure from malnutrition has been evaluated. The collected data on height, weight, and head circumference of these 87 previously malnourished children have been compared with data on height, weight, and head circumference of 559 children of the same age and sex from the same environment who have never been malnourished. The statistical analysis of the data indicate the following conclusions. 1) The survivors of marasmus are shorter and lighter and have a smaller head circumference than controls. The observed difference is statistically significant. 2) The survivors of kwashiorkor have the same physical stature as controls. 3) The survivors of marasmus are shorter and lighter and have a smaller head circumference than survivors of kwashiorkor. 4) The survivors of marasmus who were hospitalized for treatment of malnutrition when younger than 1 year have the same physical stature as the survivors of marasmus who were hospitalized for treatment of malnutrition when older than 1 year.

Adolescent↗
PubMed1977

The binding of thiopentone to kwashiorkor serum.

The binding of thiopentone to normal and kwashiorkor serum has been investigated. It has been confirmed that thiopentone is bound to albumin predominantly. In kwashiorkor serum, less binding to albumin occurs, but secondary binding sites appear. The significance of these observations is discussed.

Humans↗
PubMed1991

Aflatoxin exposure and its relationship to kwashiorkor in African children.

The urinary excretion of aflatoxins in normal children from a periurban area, as well as those hospitalized with kwashiorkor and marasmus was assessed. In no case was aflatoxin isolated from the urine. It is concluded that aflatoxin exposure is unusual in this population and that aflatoxins do not play a primary role in the pathogenesis of kwashiorkor.

Aflatoxins↗
PubMed1995

The echocardiographic findings in kwashiorkor.

Echocardiography (ECHO), electrocardiography (ECG), and chest radiography (CXR) were performed in 44 children with kwashiorkor, and 44 age- and sex-matched controls. In patients with kwashiorkor, mean values obtained for end diastolic dimension (29.2 +/- 3.8 mm), end systolic dimension (20.9 +/- 2.8 mm), posterior ventricular wall thickness (5.42 +/- 0.57 mm), and shortening fraction (28.2 +/- 4.3%) were significantly smaller than the corresponding values obtained in the controls -38.0 +/- 5.8 mm (P < 0.001), 27.6 +/- 4.5 mm (P < 0.001), 7.07 +/- 0.71 mm (P < 0.001) and 31.4 +/- 4.5% (P < 0.05), respectively. Similarly, mean cardiothoracic ratio (48.6 +/- 3.4%) and QRS amplitude (13.20 +/- 4.85 mm) were significantly (P < 0.001) smaller in subjects than controls, corresponding values being 54 +/- 3.2 per cent and 20.18 +/- 5.12 mm, respectively. In the subjects, there was very good correlation between posterior ventricular wall thickness and cardiothoracic ratio (r = 0.93; P < 0.001) and also between the estimated left ventricular mass and S1 + R6 amplitude (r = 0.89; P < 0.001).

Cardiomyopathies↗
PubMedDate not supplied

Long-term effects of early kwashiorkor compared with marasmus. III. Fine motor skills.

Children with histories of marasmus (n = 53) or kwashiorkor (n = 50) in the first year of life and healthy comparison children (n = 50) were tested for fine motor skills by the Purdue pegboard test at ages 11-18 years. The performance of children with histories of marasmus was impaired on two of the four test measures. However, the performance of children with a history of kwashiorkor was impaired on three measures. The presence of soft neurologic signs measured 6 years earlier in the same children was significantly correlated with current pegboard performance, implying that early malnutrition has effects on nervous system function that are evident at least through 18 years of age.

Adolescent↗
PubMed1979

Gentamicin pharmacokinetics in kwashiorkor.

1 Single dose intravenous gentamicin kinetics (2.4 mg/kg) were studied in six children with kwashiorkor. It was observed, that therapeutic drug concentrations were achieved which should be neither oto- nor nephrotoxic. 2 Due to the diminished glomerular filtration and renal plasma flow seen in the acute phase of kwashiorkor, gentamicin half-life was prolonged (229.0 +/- 94.8 min) at this time returning to normal (178.5 +/- 99.5 min) with nutritional rehabilitation.

Adult↗
PubMed1982

Kwashiorkor: an electron histochemical study of the hair shaft.

Previous studies on hair in kwashiorkor have been equivocal regarding the normal or abnormal incorporation of amino acids into the hair shaft. In this study we have applied a sensitive electron histochemical technique to transverse sections of scalp hair from children with severe kwashiorkor in order to study its ultrastructure and the incorporation of sulphur-containing amino acids (cystine). We have found no evidence to support the idea that a protein deficient diet in the weaning or post-weaning period directly affects the distribution and relative amounts of sulphur-containing amino acids in the hair shaft in this disease.

Child↗
PubMed1976

Fine structural studies of peripheral blood leucocytes from children with kwashiorkor: morphological and functional properties.

This is the first report of electron microscopic observation on circulating leucocytes from children with kwashiorkor, Neutrophils showed evidence of immaturity, prominent Golgi zones, granule pleomorphism; strands of endoplasmic reticulum and Döhle bodies were frequent. Although an in vitro microbicidal defect occurs with S. aureus, E. coli and C. albicans, the postphagocytic morphological events, including vacuole formation and degranulation, were normal. In mononuclear cell pellets plasmacytoid cells were frequently observed, and rare lymphoblasts occurred. The findings suggest activation of the phagocytic system and stimulation of humoral immunity in children with kwashiorkor. These fine structural observations are comparable to those which occur in trauma or thermal injury, both conditions associated with tissue breakdown and extensive antigenic stimulation.

Child↗
PubMed1980

Histopathological changes in the temporal bone in kwashiorkor.

The histopathological changes in human temporal bones are described for 2 cases of kwashiorkor--a protein/calorie malnutrition (PCM) state. There is photographic evidence of severe damge to the middle and inner ears and to the vestibulocochlear nerve. The middle ear shows evidence of chronic otitis media, a common clinical finding in kwashiorkor. Significantly, the round window membranes in both cases showed thickening and infiltration with inflammatory cells. The inner ear showed the loss of cellular elements and hair cell loss in the spiral organ. A marked decrease of spiral ganglion cells and demyelination of the vestibulocochlear nerve were also seen.

Adolescent↗
PubMed1976

Dietary effects in the early recovery phase of kwashiorkor. Plasma levels of triglycerides, FFA, D-beta-hydroxybutyrate, glycerol, postheparin lipoprotein lipase (LPL), glucose and insulin.

The fatty liver often found in untreated kwashiorkor has been associated with highly variable concentration of circulating lipids. The effect on lipid metabolism of two isocaloric diets--one synthetic monomolecular (Vivonex) and one standard (Casilan)--which both initiated satisfactory clinical improvement was studied in 21 Ethiopian children with kwashiorkor during the first weeks of rehabilitation. Before treatment mean fasting values of all biochemical parameters were within normal ranges except for moderately elevated triglycerides--an unexpected finding-and low insulin. Individual values varied greatly; triglyceride between 0.39 and 3.49 mmol/1. FFA correlated both to glycerol, D-beta-hydroxybutyrate and triglyceride values. During treatment insulin, glucose and glycerol remained essentially unchanged and were similar in both dietary groups. In the Vivonex group only there was an initial marked, parallel fall of FFA and D-beta-hydroxybutyrate suggesting greater availability of carbohydrate and enhanced glucose utilization. This pattern of response seemed to occur without comparable inhibition of lipolysis. Triglycerides--like serum albumin--increased faster in the Casilan group. The highest mean triglyceride value was reached by day 8 in the Casilan group and by day 15 in the Vivonex group. Ten minutes following heparin injection triglycerides declined, FFA and glycerol increased indicating release of in vivo active lipase. LPL activity assayed in vitro was similar and unaffected by 2 weeks of dietary treatment in both groups. LPL activity was inversely correlated to triglycerides providing--beside the type of diet--another possible explanation for the wide variations seen in circulatory triglycerides.

Blood Glucose↗
PubMed1993

Cystic fibrosis presenting as kwashiorkor with florid skin rash.

Two infants with a florid erythematous rash and generalised oedema, hypoalbuminaemia, and anaemia were found to have cystic fibrosis. This rare presentation is associated with false negative sweat tests, delays in diagnosis, and a considerable mortality. It is proposed that this presentation represents a manifestation of kwashiorkor secondary to malabsorption. The recognition that these infants have kwashiorkor provides some insight into the pathogenesis and management of their illness.

Cystic Fibrosis↗
PubMed2003

Cystic fibrosis presenting as kwashiorkor in a Sri Lankan infant.

Growth failure is a common presentation of patients with pancreatic insufficient cystic fibrosis. However, full blown kwashiorkor is extremely rare. Cystic fibrosis is also considered to be rare in the South Asian population. This report describes a Sri Lankan infant with cystic fibrosis who presented with clinical features of severe kwashiorkor.

Cystic Fibrosis↗
PubMed1968

Diarrhoea in kwashiorkor.

Diarrhoea was a common problem in the kwashiorkor seen in Kampala, contributing to the mortality and delay in recovery. Enteric infection was found in only a few children (8%), but when present it caused particularly severe diarrhoea and was frequently complicated by septicaemia.Sugar intolerance often occurred to lactose and other sugars, both monosaccharide and disaccharide. The children were most commonly intolerant of lactose, and some of these may have had a hereditary lactase deficiency.Antibiotics are rarely indicated for the treatment of diarrhoea in kwashiorkor in Kampala. If reducing substances are found in the stool of a child on a milk diet, a diet based on sucrose is substituted, and if intolerance persists a fructose diet is given. A few children are intolerant of all sugars, including fructose, and for these the prognosis is grave.

Carbohydrate Metabolism, Inborn Errors↗