1/175. Minimizing hiv/AIDS malnutrition.hiv/AIDS malnutrition influences immune function, disease progression, and quality of life. Changes in dietary intake, altered metabolism, and malabsorption are among the mechanisms that contribute to the nutritional alterations seen in hiv/AIDS. Medical-surgical nurses can help their patients minimize hiv/AIDS malnutrition through early and ongoing assessment, which guides nutritional and pharmacologic interventions.- - - - - - - - - - ranking = 1keywords = nutrition (Clic here for more details about this article) |
2/175. Total parenteral nutrition and home parenteral nutrition: an effective combination to sustain malnourished children with cancer.A patient with Wilms' tumor and severe failure to thrive required total parenteral nutrition (TPN) for "catch-up" growth. This case underscores how TPN might be useful in the management of a child with cancer. Cancer cachexia, chemotherapy, radiation, and infections caused by immune suppression can lead to potentially serious macro- and micronutrient deficiencies.- - - - - - - - - - ranking = 1.125keywords = nutrition (Clic here for more details about this article) |
3/175. Idiopathic chronic intestinal pseudo-obstruction. Use of central venous nutrition.patients with idiopathic chronic intestinal pseudo-obstruction suffer from malnutrition because of inability to maintain adequate oral intake without the development of obstructive symptoms. We have successfully used central venous nutrition in two patients with this syndrome, both on a short-term and long-term home-maintenance basis. Hyperalimentation can provide adequate nutrition in patients with intestinal pseudo-obstruction until normal bowel function returns or until definitive therapy for this chronic disease is found.- - - - - - - - - - ranking = 0.875keywords = nutrition (Clic here for more details about this article) |
4/175. Psychological factors in nutritional disorders of the elderly: part of the spectrum of eating disorders.OBJECTIVE: To illustrate common psychogenic factors involved in undereating and undernutrition in the elderly. METHOD: Two cases are described. RESULTS: In the context of age-related physical and social factors, obsessional, phobic, and hypochondriacal anxieties can lead to significant food restrictions and undernutrition. DISCUSSION: Psychogenic factors need to be considered in undernutrition of the elderly and the phenomena considered in the spectrum of eating disorders.- - - - - - - - - - ranking = 0.875keywords = nutrition (Clic here for more details about this article) |
5/175. Reduced growth hormone receptor messenger ribonucleic acid in an aged man with chronic malnutrition and growth hormone resistance.A severely malnourished 87-yr-old man presented with hypoglycemia. serum GH levels were elevated, and serum levels of insulin-like growth factor i (IGF-I), IGF-binding protein-3, and GH-binding protein were extremely reduced. The patient's GH was biologically active. Administration of GH for 4 consecutive days resulted in a slight increment in serum IGF-I levels, but no elevation of serum IGF-binding protein-3. The expression of GH receptor messenger ribonucleic acid in the liver was greatly reduced. An autopsy revealed a Rathke's cleft cyst confined to the sella turcica. Immunohistochemical studies for GH showed that there was nothing to suggest a tumor overproducing GH. In addition, TSH levels were elevated in the presence of normal thyroid hormone levels, and there was a cluster of cells showing strong immunohistochemical staining for the TSH beta-subunit in the pituitary. In this patient, the decreased expression of GH receptor messenger ribonucleic acid in the liver may have been responsible for the GH resistance, which was probably caused by malnutrition.- - - - - - - - - - ranking = 0.625keywords = nutrition (Clic here for more details about this article) |
6/175. anorexia nervosa with severe liver dysfunction and subsequent critical complications.A twenty-year-old woman with anorexia nervosa (body mass index=11) suffered from severe liver dysfunction (aspartate aminotransferase 5,000 IU/l, alanine aminotransferase 3,980 IU/l, prothrombin time 32%), hypoglycemia (serum glucose 27 mg/dl), and pancreatic dysfunction (amylase 820 IU/l, lipase 558 IU/l). She fell into a depressive state with irritability, which was not improved by intravenous glucose. Despite treatment with plasmapheresis for the liver dysfunction, she subsequently developed pulmonary edema, acute renal failure, gastrointestinal bleeding, and disseminated intravascular coagulation. Hemodialysis, mechanical ventilation and drug therapy including prednisolone, prostaglandin E1, and branched-chain amino acid, improved her critical condition. In this case, malnutrition may have been the cause for the liver dysfunction and subsequent complications.- - - - - - - - - - ranking = 0.125keywords = nutrition (Clic here for more details about this article) |
7/175. Liquid pancreatic enzyme therapy for a patient with short bowel syndrome and chronic pancreatitis in a complicated case of Crohn's disease.The case of a 45 year old female with multiple complications of Crohn's disease is reported. After multiple resections in the gastrointestinal tract she had been suffering from short bowel syndrome and severe malnutrition. With a special continuous gastric tube feeding system, she was able to maintain her weight for years. In the beginning of 1997 the enteral nutrition was not longer tolerated for an exacerbation of chronic pancreatitis. There was a weight loss, permanent pain and total parenteral nutrition had to be performed. In this situation a new liquid preparation of pancreatic enzymes which had been tested in the laboratory before, was used for continuous enzyme replacement via gastric tube. In combination with this enzyme preparation, enteral nutrition could successfully be started again.- - - - - - - - - - ranking = 0.5keywords = nutrition (Clic here for more details about this article) |
8/175. Huntington's disease: review and anesthetic case management.Huntington's disease is a dominantly inherited progressive autosomal disease that affects the basal ganglia. Symptoms appear later in life and manifest as progressive mental deterioration and involuntary choreiform movements. patients with Huntington's disease develop a progressive but variable dementia. Dysphagia, the most significant related motor symptom, hinders nutrition intake and places the patient at risk for aspiration. The combination of involuntary choreoathetoid movements, depression, and apathy leads to cachexia. Factors of considerable concern to the anesthesiologist who treats patients with Huntington's disease may include how to treat frail elderly people incapable of cooperation, how to treat patients suffering from malnourishment, and how to treat patients with an increased risk for aspiration or exaggerated responses to sodium thiopental and succinylcholine. The successful anesthetic management of a 65-yr-old woman with Huntington's disease who presented for full-mouth extractions is described.- - - - - - - - - - ranking = 0.125keywords = nutrition (Clic here for more details about this article) |
9/175. lymph loss in the bowel and severe nutritional disturbances in Crohn's disease.A severe nutritional deficiency status is described in a 22-year-old patient with Crohn's disease. The clinical picture on admission was dominated by an episode of gastrointestinal bleeding secondary to clotting disturbances (vitamin k deficiency) and severe cachexia due to a protein energy malnutrition. The mechanisms of severe nutritional disturbances in Crohn's disease are multifactorial. In this patient, lymphatic leakage into the intestinal lumen was a major contributing factor in the pathogenesis of protein-losing enteropathy, fat malabsorption, and lymphocytopenia. The authors were able to demonstrate this intestinal lymph loss by nuclear imaging.- - - - - - - - - - ranking = 0.875keywords = nutrition (Clic here for more details about this article) |
10/175. Nutritional deficiencies in a patient with glycogen storage disease type Ib.The current mainstay of treatment in glycogen storage disease type i (GSD I) is dietary management that includes providing a frequent source of glucose to prevent hypoglycaemia. To ensure compliance, routine follow-up by a health care team, including a dietitian, experienced in the treatment of GSD is necessary. We describe an adolescent patient with GSD Ib in good metabolic control who was admitted with a 3-month history of weakness, depression, vomiting, decreased appetite and a 11.4-kg weight loss. He had a recent onset of unsteady gait, inability to write, and sore mouth. After an extensive work-up, the patient was found to have vitamin B12, folate, iron and other nutritional deficiencies, which explained his symptoms. The patient improved within 72 h of initiation of total parenteral nutrition and therapeutic doses of deficient micronutrients, with a complete recovery in 2 months. Dietary restrictions, dependence on non-food products (e.g. cornstarch in GSD I), and social and developmental issues place individuals with metabolic disorders at a high risk for developing an array of nutritional deficiencies. This case highlights the importance of both close follow-up of the metabolic control and close monitoring of growth and nutritional intake in individuals with inborn errors of metabolism. This case also illustrates the importance of daily supplementation with appropriate multivitamins, calcium and other minerals needed to meet the Recommended Dietary Allowances (RDAs) in these patients.- - - - - - - - - - ranking = 0.5keywords = nutrition (Clic here for more details about this article) |
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