Cases reported "Malnutrition"

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11/37. stroke and seizure following a recent laparoscopic Roux-en-Y gastric bypass.

    Laparoscopic Roux-en-Y gastric bypass (LRYGBP) has been an available operation for weight loss for the past decade, and bariatric surgery is increasing in the united states. Careful patient screening and follow-up have been the cornerstone for success against the complexities of morbid obesity. Neurologic complications have occurred, such as polyneuropathy and Wernicke-korsakoff syndrome. We report an 18-year-old female with morbid obesity, steatohepatitis, tobacco, recreational drug, and oral contraceptive use who at 4 months after LRYGBP experienced a generalized seizure and stroke. She was diagnosed with an acute ischemic stroke, possibly venous infarction. Her postoperative course had been complicated by malnutrition and dehydration, apparently related to nausea from chronic cholecystitis. She had a possible protein-S deficiency. Rare neurologic complications emphasize the importance of postoperative surveillance in these patients. ( info)

12/37. Effect of enzyme-replacement therapy on gastrointestinal symptoms in fabry disease.

    fabry disease is an X-linked recessive lysosomal storage disorder caused by deficiency of lysosomal alpha-galactosidase A. The disease affects not only kidney, myocardium, central nervous system and the skin but also, in many patients, the gastrointestinal tract. The recent advent of enzyme-replacement therapy has been reported to show beneficial effects on cardiomyopathy, renal function and autonomous nervous function. We report on a 34-year-old patient with fabry disease in whom gastrointestinal symptoms were major complaints. Enzyme replacements led to remarkable improvement of diarrhoea and constipation. abdominal pain, the feeling of fullness and meteorism improved, and metoclopramide, which previously had been used regularly, could be discontinued. There were also marked improvements of appetite, body weight, body mass index, physical activity and overall wellbeing. This observation should prompt further investigations into the pathophysiology of gastrointestinal manifestations in fabry disease and the mechanisms of enzyme-replacement effects on gut function. ( info)

13/37. malnutrition in older people--screening and management strategies.

    BACKGROUND: malnutrition in older people is not only common, but frequently overlooked. It can result in multiple medical complications, hospitalisation and even death. OBJECTIVE: This article focusses on the consequences, pathophysiology, diagnosis and management of this clinical syndrome. DISCUSSION: Nonphysiological causes of malnutrition include social, psychological, medical and medication related factors. With vigilance, early screening and the institution of simple therapeutic measures of correcting nonphysiological causes and following dietary guidelines for older people, the adverse effects of malnutrition may be minimised. ( info)

14/37. lymphoma creating colojejunal fistula: report of a case and review of the literature.

    Malignant fistula of the colon to the small bowel is rare and is most often due to adenocarcinoma. Colonic lymphoma is unusual, representing only 0.5 percent of all colonic malignancies. We report a case of intestinal lymphoma presenting with diarrhea and malnutrition. A colojejunal fistula was discovered during colonoscopy by biopsy of small bowel through a fistula in the sigmoid colon. Celiotomy revealed a 12 cm mass in the sigmoid colon with a fistula to the jejunum. pathology was consistent with T-cell lymphoma. This is a rare entity in a nonimmunocompromised host and has not been described in the English literature. ( info)

15/37. Problems with eating and nutrition: geriatric self-learning module.

    The Geriatric Resource Nurse Model is used at the University of virginia to improve the competency of staff in caring for older adults. Eight self-learning educational modules were developed to address common concerns in hospitalizedelders. The Problems With eating and Nutrition: Geriatric Self-learning Module is published here, along with a post test. This is the second in a four-part publication of self-learning modules. ( info)

16/37. Exfoliative erythema of malnutrition with zinc and essential amino acid deficiency.

    We present a patient with a desquamating predominantly flexural erythema and glossitis due to a combination of alcoholism, zinc deficiency and amino acid deficiency. A similar clinical picture to necrolytic migratory erythema can be seen with zinc deficiency or protein malnutrition, often in patients with alcoholic liver disease, in the absence of glucagonoma. The speed of clinical improvement following zinc replacement therapy, usually within days to weeks, is striking, confirming the clinical diagnosis. ( info)

17/37. Severe hypophosphatemia in a patient with anorexia nervosa during enteral refeeding.

    hypophosphatemia is a seldom but potentially fatal complication of the nutritional recovery or refeeding syndrome in patients with protein-calorie malnutrition or starvation. We report here the case of a 35-year-old anorexic patient who presented a severe but uncomplicated hypophosphatemia during enteral refeeding, despite phosphorus supplementation. serum phosphorus monitoring is recommended in severely malnourished anorexic patients, particularly during the first week of refeeding, be it parenteral or enteral. ( info)

18/37. Spinal epidural abscess-from onset to rehabilitation: case study.

    Spinal epidural abscess (SEA) is a rare condition; consequently, the clinical significance of early diagnosis often is overlooked. The challenge with SEA is not its treatment, but achieving early diagnosis before neurological symptoms occur. Once neurological deficits are present, immediate treatment must be implemented to prevent deterioration that can result in paralysis. The common SEA signs and symptoms are fever, back pain, and radicular symptoms that can progress to weakness and paralysis. magnetic resonance imaging is the imaging of choice for diagnosis. Treatments include antibiotics and surgical evacuation of the abscess if neurologic deficits are present. nurses play a major role in caring for SEA patients by identifying those at risk, preventing complications, and collaborating with a multidisciplinary team to prepare patients for rehabilitation. ( info)

19/37. Nutritional deficiencies and the skin.

    malnutrition states are relatively uncommon in the UK but we have seen two recent cases which have heightened our awareness of both dermatological manifestations of malnutrition and of nutritional sequelae of a dermatological problem. Case 1 is a patient with anorexia nervosa presenting with features of pellagra. This condition is due to deficiency of niacin and responds rapidly to replacement therapy. Classical presentation is an erythematous rash on photoexposed sites, often related to heat or friction. There are three reported cases of pellagra occurring in patients with anorexia nervosa. Case 2 is an adult atopic with sensitizations to multiple foodstuffs. A self-imposed restriction diet caused multiple nutritional deficiencies. Restriction diets in adult atopics are not particularly common in the UK, but there is some evidence to suggest that they may cause significant nutritional deficiency. A nutrition screen may be indicated more frequently than is currently recognized. ( info)

20/37. Extra pontine myelinolysis associated with hypophosphatemia.

    We report a unique association of extra-pontine myelinolysis with severe hypophosphatemia developing in a young lady with a prolonged febrile illness and inadequate oral intake.The late identification of severe hypophosphatemia resulted in extra-pontine myelinolysis. Gradual improvement in clinical status was noticed with phosphate replacement and good supportive care. ( info)
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