• Title/Summary/Keyword: malnourished

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Utilization of a Scored Patient-Generated Subjective Global Assessment in Detecting a Malnourished Status in Gynecologic Cancer Patients

  • Chantragawee, Chompunut;Achariyapota, Vuthinun
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.9
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    • pp.4401-4404
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    • 2016
  • Purpose: To assess the prevalence of malnutrition in gynecologic cancer patients using the Scored Patient-Generated Subjective Global Assessment (PG-SGA) questionnaire. Materials and Methods: A total of 97 gynecologic cancer patients who never had any treatment but were planned for surgery were enrolled. The patients were asked to complete the scored PG-SGA form before the treatment was started. Attending physicians were also asked to complete other information in the PG-SGA form. Total scores were calculated and the patients were classified into 3 nutritional status levels. Results: Mean age was 54 years. Postoperative diagnoses were endometrial cancer in 42 cases (43.2%), ovarian cancer in 29 cases (29.9%), and cervical cancer in 26 cases (26.8%). Mean PG-SGA score was 5.2+4.7. Malnutrition (PG-SGA B and C) was found in 52 patients (53.6%, 95% CI 43.7% - 63.2%). Preoperative BMI, hemoglobin, serum albumin, and cancer stage were not significantly associated with nutritional status. Malnutrition was significantly more common among patients diagnosed with ovarian cancer, compared to other types of cancer (79.3% vs. 42.6%, p 0.004). Conclusions: Prevalence of malnutrition among gynecologic cancer patients was 53.5%, according to the scored PG-SGA. Malnutrition was significantly more common among patients with ovarian cancer.

Factors Affecting Malnutrition in Hemodialysis Patients (혈액투석 환자의 영양장애 영향요인)

  • Park, Ok Lae;Jang, Young Jun;Jung, Jong Hwan;Kim, Sung Reul
    • Korean Journal of Adult Nursing
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    • v.28 no.2
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    • pp.226-236
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    • 2016
  • Purpose: The aim of this study was to evaluate the nutritional status and to identify factors affecting malnutrition in hemodialysis patients. Methods: Data were collected from a convenience sample of 125 hemodialysis patients who agreed to participate in the study, between August 1 and October 4, 2014. Five structured questionnaires were used: Patient-generated Subjective Global Assessment, Simplified Nutritional Appetite Questionnaire, Self-rating Depression Scale, Fatigue Scale, and Family Support Scale. Data were analyzed by descriptive statistics, t-test, Mann-Whitney U test, ${\chi}^2$-test, and stepwise multiple regression analysis by using SPSS/WIN 22.0 program. Results: Of 125 patients, 30.4% were found to be malnourished. Malnutrition was related to age, family household income, depression, fatigue, social support, appetite, and levels of C-reactive protein and serum albumin. Stepwise multiple regression analysis showed that appetite, C-reactive protein level, fatigue, and albumin level were significant factors affecting malnutrition in hemodialysis patients. Conclusion: Regular and consistent nutritional assessment is essential in hemodialysis patients. Nurses who care for hemodialysis patients need to consider the factors identified from these findings when assessing their patients' nutritional status and needs.

The Effect of Total Parenteral Nutrition on Hospitalized Patients according to Nutritional Status (입원 환자의 영양상태에 따른 TPN(Total Parenteral Nutrition) 공급 현황 및 TPN 공급 효과 비교)

  • 배제헌;김순경
    • Korean Journal of Community Nutrition
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    • v.8 no.4
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    • pp.574-583
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    • 2003
  • The purpose of this study was to investigate the anthropometry, biochemical parameters and electrolytes concentrations of the Total Parenteral Nutrition (TPN) patients according to their nutritional status at the time of admission. Thirty-three patients in the Intensive Care Unit at S University Hospital were the subjects of this study. Their nutritional status was classified as At-risk I (Mild PCM, n = 13), At - risk II (Moderate PCM, n = 9) and At-risk III (Marasmus + kwashiorkor + severe PCM, n = 11) . Anthropometeric, biochemical and dietary assessments were performed. The Patients intake of calories (75.02%) and protein (53.15%) was insufficient compare with Korean RDA requirements. The body weight and the Body Mass Index (BMI) in the At-risk III group were significantly lower than in the other groups. The percentage of body weight loss and change of body weight (kg) were significantly higher than in the other groups. The subjects were malnourished as indicated by nutritional related parameters such as serum total protein, albumin, total lymphocyte count (TLC), hemoglobin and hematocrit. Serum total protein, albumin and TLC levels were lower at the time of admission before TPN administration. But after TPN administration, they increased. The electrolyte concentrations did not show any differences following TPN administration. The nutritional status of the patients could be affect by the duration of TPN administration and the number of days of the patients hospitalization. The patients who require nutritional support need the continuous follow-up care and monitoring by a nutritional support team. (Korean J Community Nutrition 8(4) : 574-583, 2003)

Copper Deficient Anemia in Severe Protein-Energy Malnutrition due to Child Abuse (아동학대로 인해 발생한 중증 단백-에너지 영양실조 환아에서 동반된 구리결핍증 빈혈 1예)

  • Byun, Sung-Hwan;Jeon, Je-Deok;Chang, Soo-Hee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.1
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    • pp.60-65
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    • 2007
  • An unconscious 5-year-old girl was admitted to the Intensive Care Unit. She was neglected by her parents; she suffered from inadequate nutritional, medical and emotional care. The girl appeared to be emotionally detached, dehydrated and malnourished; she had edematous extremities, moderately bruised skin and brittle coarse hair. Laboratory testing showed electrolyte imbalance, anemia, pneumonia, copper deficiency, and liver dysfunction in addition to severe protein-energy malnutrition (PEM). Medical intervention was followed by improvement of most of the symptoms. During the rehabilitation phase, the patient showed a voracious appetite and gained weight too fast. The liver became enlarged and the patient developed a mild fever due to excessive nutrition. The microcytic anemia with severe PEM did not responded to iron supplementation possibly due to the copper deficiency. Addition of copper without zinc and iron helped to improve the anemia. The patient was discharged to a childcare center where she received cognitive and psychosocial therapy.

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Feeding and Nutritional Status of Elderly Patients receiving Enteral Tube Feeding (경관급식 노인 환자의 영양공급실태와 영양상태 평가)

  • Yoon, Hwa-Young;Kim, Hye-Kyeong
    • The Korean Journal of Food And Nutrition
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    • v.31 no.1
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    • pp.52-61
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    • 2018
  • The purpose of this study is to examine the feeding and nutritional status of enteral tube-fed elderly patients. Subjects included 77 elderly hospitalized patients who had received enteral nutrition more than one week before admission. Medical records on admission and actual feeding volume were used to assess anthropometric, biochemical, and nutritional status. Most patients manifested disorders of the nervous system (93.5%) and the average duration of tube feeding was 13.9 months. The average feeding volume of formula was 1,107 mL per day and the mean ratios of calorie and protein (supplied vs. required) were 81.7% and 80.9%, respectively. At admission, 57.4% of the patients were malnourished according to the institutional criteria. Patients receiving less than 80% of the required calories were in worse nutritional status compared with those receiving more than 80% of the required calories. Body mass index, percent ideal body weight, serum albumin level and blood lipid levels (total cholesterol, HDL-cholesterol, triglyceride) were significantly lower in patients receiving less than 80% of the required calories. These results indicate the high prevalence of malnutrition and the need for increased attention and nutritional care of elderly patients undergoing long-term enteral nutrition.

The Effect of Enteral Nutritional Support in Cancer Patients (암 환자에서의 경구 영양 보충 효과에 관한 연구)

  • 문수재
    • Journal of Nutrition and Health
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    • v.27 no.3
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    • pp.281-291
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    • 1994
  • The purpose of this study was to investigate the effectiveness of enteral nutritional support to cancer patients who were clinically malnourished and receiving chemotherapy after surgery. To estimate the effect of nutritional support using Greenbia(Dr. Chung's Food Cooperation, LTD., Seoul, Korea) for patients with cancer, 41 patients were participated between January 1991 to November 1991. All patients were randomized into 2 groups and 18 patients were evaluated(experimental group : 12, control group : 6). The counseling was carried out once a week for 2 months. To compare the nutrient intake before and after administration of nutritional beverage and to identify the potential effectiveness of nutritional support in this group, a record of this diet on all patients during the test period was carried out for 3 days. To evaluate the patients nutritional status, the anthropometric parameters and serum protein were checked at the begining as baseline, week 3, week 6, and at the end of the test(week 8). In the case of energy balance, no patients appeared to be positive before administration of nutritional beverage, while 2 patients among 12 were observed to be more than 100% positive after administration. There were some differences among the experimental group which had administration of nutritional beverage but most of the results of anthropometric parameters were improved. When comparing the experimental and control group, there was significant increase in body weight, body fat, arm circumference and tricep skinfold. This study suggests that enteral nutritional support can help improving the nutritional status of patients received chemotherapy.

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Resolution of Protein-Losing Enteropathy after Congenital Heart Disease Repair by Selective Lymphatic Embolization

  • Kylat, Ranjit I;Witte, Marlys H;Barber, Brent J;Dori, Yoav;Ghishan, Fayez K
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.6
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    • pp.594-600
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    • 2019
  • With improving survival of children with complex congenital heart disease (CCHD), postoperative complications, like protein-losing enteropathy (PLE) are increasingly encountered. A 3-year-old girl with surgically corrected CCHD (ventricular inversion/L-transposition of the great arteries, ventricular septal defect, pulmonary atresia, postdouble switch procedure [Rastelli and Glenn]) developed chylothoraces. She was treated with pleurodesis, thoracic duct ligation and subsequently developed chylous ascites and PLE (serum albumin ${\leq}0.9g/dL$) and was malnourished, despite nutritional rehabilitation. Lymphangioscintigraphy/single-photon emission computed tomography showed lymphatic obstruction at the cisterna chyli level. A segmental chyle leak and chylous lymphangiectasia were confirmed by gastrointestinal endoscopy, magnetic resonance (MR) enterography, and MR lymphangiography. Selective glue embolization of leaking intestinal lymphatic trunks led to prompt reversal of PLE. Serum albumin level and weight gain markedly improved and have been maintained for over 3 years. Selective interventional embolization reversed this devastating lymphatic complication of surgically corrected CCHD.

The role of nutritional status in the relationship between diabetes and health-related quality of life

  • Park, Sohyun;Jung, Sukyoung;Yoon, Hyunsook
    • Nutrition Research and Practice
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    • v.16 no.4
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    • pp.505-516
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    • 2022
  • BACKGROUND/OBJECTIVES: The association between nutritional status and health-related quality of life (HRQoL) among patients with type 2 diabetes mellitus (T2DM) is not fully understood. This study was conducted to understand the role of nutritional status on HRQoL among people with and without T2DM. SUBJECTS/METHODS: Structured survey and direct measurement of anthropometric data were conducted among people with and without T2DM. Nutritional status was measured with Mini Nutritional Assessment tool and HRQoL was measured with a 36-item Short Form Healthy Survey. Data collection was conducted in Chuncheon, South Korea with 756 participants who are older than 40 yrs of age. RESULTS: This study found that overall HRQoL were significantly lower in people with T2DM than people without T2DM after controlling for key covariates. When stratified by nutritional status, a greater degree of negative impact of T2DM on overall physical HRQoL was observed among well-nourished or at risk of malnutrition, whereas significant and more evident negative impact of diabetes on overall psychological HRQoL was observed only among malnourished. CONCLUSIONS: The study results suggest the role of nutritional status among people with T2DM on overall, especially psychological aspects of HRQoL. Future longitudinal or intervention studies are warranted to test the impact of nutritional status on HRQoL among people with T2DM.

Hair Zinc Level Analysis and Correlative Micronutrients in Children Presenting with Malnutrition and Poor Growth

  • Han, Tae Hwan;Lee, Jin;Kim, Yong Joo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.19 no.4
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    • pp.259-268
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    • 2016
  • Purpose: Zinc deficiency can induce serious clinical problems in the gastrointestinal (GI) system and immune system and can affect growth and development. It is more severe in younger patients. Chronic zinc deficiency is reflected more precisely in hair than in serum. We studied hair zinc levels and other hair and serum micronutrients in chronic malnourished children to identify which micronutrients are affected or correlated with the other ones. Methods: Hair mineral analyses were performed in 56 children (age, 1-15 years) presenting with malnutrition, poor growth, poor appetite, anorexia, with/without other GI symptoms (diarrhea, abdominal pain, constipation) from August 2012 to March 2015. Biochemical studies for macronutrients and major micronutrients were also conducted. Results: Hair zinc deficiency was diagnosed in 88%, and serum zinc deficiency was diagnosed in 55% of the children. There was no statistical correlation between serum and tissue zinc level. Hair zinc levels were highly correlated with serum vitamin D (r=-0.479, p=0.001), which also showed correlation with hair levels of magnesium and calcium. (r=0.564, 0.339, p=0.001, 0.011). Hair calcium level was correlated with serum pre-albumin (r=0.423, p=0.001). These correlations may explain the phenomenon that the major clinical manifestation of zinc deficiency is poor body growth. Clinical symptoms were resolved in most children after zinc supplementation. Conclusion: Hair zinc and mineral analyses are useful as a therapeutic guide in the clinical investigation of children with malnutrition and poor growth.

Relationship between intra-household food distribution and coexistence of dual forms of malnutrition

  • Wibowo, Yulianti;Sutrisna, Bambang;Hardinsyah, Hardinsyah;Djuwita, Ratna;Mondastri, Korib M.;Syafiq, Ahmad;Tilden, Atmarita;Najib, Mardiati
    • Nutrition Research and Practice
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    • v.9 no.2
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    • pp.174-179
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    • 2015
  • BACKGROUND/OBJECTIVES: The relationship between food intake and nutritional status has been clearly established. Yet, there are only limited studies on food intake among family members and their nutritional status. The study examined the relationship between intra-household food distribution and coexistence of dual forms of malnutrition (DFM) in the same household. SUBJECTS/METHODS: Households with a malnourished child and overweight mother were categorized as DFM. Intra-household food distribution among family members was reported using ratios, which are a measure of individual intakes as compared to all household member intakes adjusted to RDA. RESULTS: A1,899 families were included in the study. The prevalence of DFM was 29.8% (95%CI 26.5-31.2). Children consumed lower amounts of energy (OR 1.34; 95%CI 1.06-1.69, P = 0.011), carbohydrates (OR 1.2; 95%CI1.03-1.61, P = 0.022), protein (OR 1.3; 95%CI 1.03-1.64, P = 0.026), and fat (OR 1.3; 95%CI 1.05-1.66, P = 0.016) than their mothers and other family members. In contrast, mothers consumed more carbohydrates than children and other family members (OR1.24; 95%CI 1.02-1.51, P = 0.03). CONCLUSIONS: This study is the first to report on the food distribution among family members and its relationship with occurrence of DFM in Indonesia. The results confirm the occurrence of an unequal food distribution between children and mothers, which increases risk of DFM in the household. The results also demonstrate that nutritional education at the household level is important to increase awareness of the impact of DFM.