Although the increase in the frequency of mass wasting events in the Sedongpu gully in recent years indicates that the Sedongpu gully has entered an intense mass wasting period,the current literature focuses only on i...Although the increase in the frequency of mass wasting events in the Sedongpu gully in recent years indicates that the Sedongpu gully has entered an intense mass wasting period,the current literature focuses only on ice‒rock avalanche events and lacks comprehensive knowledge of Sedongpu gully activity.To clarify the spatiotemporal distribution and scales of mass wasting events,we analysed multiple images from 1969 to present(including optical images and synthetic aperture radar(SAR)images)and topography data from 2013 to present.Since 1969,there have been at least 19 obvious mass wasting events that can be divided into 3 subpatterns:ice‒rock avalanches(IRAs,8 events),ice‒moraine avalanches(IMAs,2 events),and glacier debris flows(GDFs,9 events).Since 2017,the Sedongpu gully has entered the most active period,i.e.more than 68%of events occurred after 2017,and approximately 530 Mm^(3)and 185 Mm^(3)of materials were removed from mixtures of glacial and moraine(MGM)and glacial source areas(GSAs).Recent continuous warning states that the temperature of the Sedongpu gully area exceeded 0℃ from April to July 2012,and the 2017 Mw 6.4 Nyingchi earthquake was critical in the current intense erosion state.展开更多
Transmissible spongiform encephalopathies(TSEs)are a group of progressive and ultimately fatal neurologic diseases of man and animals,all resulting from the propagated misfolding of the host's normal cellular prio...Transmissible spongiform encephalopathies(TSEs)are a group of progressive and ultimately fatal neurologic diseases of man and animals,all resulting from the propagated misfolding of the host's normal cellular prion protein.These diseases can be spontaneous,heritable,anthropogenic/iatrogenic,or in some cases horizontally transmissible,and include such notable TSEs as bovine spongiform encephalopathy(BSE)of cattle and chronic wasting disease(CWD)of cervids.Although they are both unequivocally protein misfolding disorders,they differ markedly in their pathogenesis,transmissibility,and zoonotic potential.While the BSE epidemic has largely abated over the past three decades following global feed bans on ruminant meat and bone meal,CWD,which is readily transmitted through various forms of excreta,has rapidly expanded from its original endemic zone to encompass much of North America,along with recently identified foci in Scandinavia.Most importantly,although the classical form of BSE has proven transmissible to humans consuming contaminated beef or beef products,so far there have been no conclusive reports on the zoonotic transmission of cWD to humans.The underlying basis for these differences-whether host or agent directed-are not well understood,though may be due to inherent differences in the three-dimensional structure of the misfolded BSE or CWD prion proteins or the expression levels and tissue distribution of respective cellular prion proteins.With the uncontrolled geographic spread of CWD,it is imperative that we improve our understanding of the factors governing prion disease pathogenesis,transmission,and zoonotic potential.展开更多
Muscle wasting is defined as the progressive and generalized loss of muscle mass. Muscle depletion is a common feature of chronic liver disease foundin approximately 40% of patients with cirrhosis. Its etiology is mul...Muscle wasting is defined as the progressive and generalized loss of muscle mass. Muscle depletion is a common feature of chronic liver disease foundin approximately 40% of patients with cirrhosis. Its etiology is multifactorial subsequent to liver failure and its prevalence increases along with disease severity. Cross-sectional analytic morphometry using computed tomography(CT) scan or magnetic resonance imaging are considered by consensus the gold standards to assess muscle size in cirrhosis for research purposes because they are not biased by fluid accumulation. Several studies have assessed the impact of muscle wasting on overall survival of patients in the waiting list for liver transplantation and there is a general agreement that decreased muscle size assessed by CT scan is an independent predictor for mortality in cirrhosis. It has been proposed that the addition of cross-sectional muscle area into the Model for End-stage Liver Disease can increase its prognostic performance. Nevertheless, the use of CT scan in assessing muscle size is inappropriate for routine clinical practice and an alternative cost-effective, easy to use and accurate tool should be developed. In conclusion, muscle wasting has a detrimental impact on survival of patients with cirrhosis and, thus, it remains to be elucidated if nutritional interventions and exercise could improve muscle wasting and, subsequently, survival in this setting.展开更多
Rheumatoid arthritis(RA), the commonest inflammatory arthritis, is a debilitating disease leading to functional and social disability. In addition to the joints, RA affects several other tissues of the body including ...Rheumatoid arthritis(RA), the commonest inflammatory arthritis, is a debilitating disease leading to functional and social disability. In addition to the joints, RA affects several other tissues of the body including the muscle. RA patients have significantly less muscle mass compared to the general population. Several theories have been proposed to explain this. High grade inflammation, a central component in the pathophysiology of the disease, has long been proposed as the key driver of muscle wasting. More recent findings however, indicate that inflammation on its own cannot fully explain the high prevalence of muscle wasting in RA. Thus, thecontribution of other potential confounders, such as nutrition and physical activity, has also been studied. Results indicate that they play a significant role in muscle wasting in RA, but again neither of these factors seems to be able to fully explain the condition. Oxidative stress is one of the major mechanisms thought to contribute to the development and progression of RA but its potential contribution to muscle wasting in these patients has received limited attention. Oxidative stress has been shown to promote muscle wasting in healthy populations and people with several chronic conditions. Moreover, all of the aforementioned potential contributors to muscle wasting in RA(i.e., inflammation, nutrition, and physical activity) may promote pro- or antioxidative mechanisms. This review aims to highlight the importance of oxidative stress as a driving mechanism for muscle wasting in RA and discusses potential interventions that may promote muscle regeneration via reduction in oxidative stress.展开更多
The coexistence of different water homeostasis abnormalities following neurosurgery represents a diagnostic and therapeutic challenge for intensive care units. This paper reports the case of a 13 year-old boy who unde...The coexistence of different water homeostasis abnormalities following neurosurgery represents a diagnostic and therapeutic challenge for intensive care units. This paper reports the case of a 13 year-old boy who underwent surgery for a suprasellar tumour and, immediately after surgery, developed a cerebral abscess, persistent diabetes insipidus (DI) as well as cerebral salt wasting syndrome (CSWS). The early onset of CSWS following DI has been associated with a poor prognosis and increased mortality. In cases in which these abnormalities coexist, the increased polyuria secondary to the rise in natriuresis associated with CSWS might be erroneously interpreted as a sign of poor control of the DI, thereby leading to therapeutic mistakes. Treatment basically consists of restoring electrolytes and the joint administration of desmopressin and fludrocortisone.展开更多
AIM To identify patients with end-stage renal disease treated by peritoneal dialysis(PD)who had zero body fat(BF)as determined by analysis of body composition using anthropometric formulas estimating body water(V)and ...AIM To identify patients with end-stage renal disease treated by peritoneal dialysis(PD)who had zero body fat(BF)as determined by analysis of body composition using anthropometric formulas estimating body water(V)and to compare nutritional parameters between these patients and PD patients whose BF was above zero.METHODS Body weight(W)consists of fat-free mass(FFM)andBF.Anthropometric formulas for calculating V allow the calculation of FFM as V/0.73,where 0.73 is the water fraction of FFM at normal hydration.Wasting from loss of BF has adverse survival outcomes in PD.Advanced wasting was defined as zero BF when V/0.73 is equal to or exceeds W.This study,which analyzed 439 PD patients at their first clearance study,used the Watson formulas estimating V to identify patients with V_(Watson)/0.73≥W and compared their nutritional indices with those of PD patients with V_(Watson)/0.73<W.RESULTS The study identified at the first clearance study two male patients with V_(Watson)/0.73≥W among 439 patients on PD.Compared to 260 other male patients on PD,the two subjects with advanced wasting had exceptionally low body mass index and serum albumin concentration.The first of the two subjects also had very low values for serum creatinine concentration and total(in urine and spent peritoneal dialysate)creatinine excretion rate while the second subject had an elevated serum creatinine concentration and high creatinine excretion rate due,most probably,to non-compliance with the PD prescription.CONCLUSION Advanced wasting(zero BF)in PD patients,identified by the anthropometric formulas that estimate V,while rare,is associated with indices of poor somatic and visceral nutrition.展开更多
Background Muscle wasting is a common clinical phenomenon that affects at least 20 percent of patients with heart failure. The exercise capacity of heart failure patients is limited; if left unchecked, which can form ...Background Muscle wasting is a common clinical phenomenon that affects at least 20 percent of patients with heart failure. The exercise capacity of heart failure patients is limited; if left unchecked, which can form ca- chexia, seriously affecting the quality of life of patients with heart failure. This paper summarizes the clinical manifestations, pathophysiological mechanisms and its latest research direction including microRNA-regulated networks, and potential therapeutic strategies of muscle wasting in heart failure. Our goal is to provide a basis for clinicians to further understand and treat the muscle wasting in heart failure patients.展开更多
The aim of the study is to monitor and assess landslide hazards by remote sensing data processing and GIS （Geographic Information Service） spatial analysis. Idukki district, the western Ghats of India was chosen as ...The aim of the study is to monitor and assess landslide hazards by remote sensing data processing and GIS （Geographic Information Service） spatial analysis. Idukki district, the western Ghats of India was chosen as test area, because of frequent destructive mass wasting processes. Western Ghats is a prominent orographic feature that runs parallel to the south west coast of India. Predicting landslide hazard on a regional scale, namely the assessment of actual and potential mass movement over large area is carried out using Remote Sensing and GIS. A numerical weightage to the causative factors of slope instability such as slope, relative relief, aspect, curvature, drainage density, drainage frequency, land use, road buffer and drainage buffer are assigned as per earlier workers for the purpose of landslide susceptibility zonation. A high degree of match is found between observed and predicted landslide hazard by the procedure employed in the study.展开更多
Protein energy wasting (PEW) is a major challenge in CKD. Objective: To assess PEW in predialysis patients on their first visit to a nephrologist. Methods: Three day dietary intake of 484 CKD stage 3 patients was take...Protein energy wasting (PEW) is a major challenge in CKD. Objective: To assess PEW in predialysis patients on their first visit to a nephrologist. Methods: Three day dietary intake of 484 CKD stage 3 patients was taken. Appetite was assessed with ADAT. Patients were divided into groups based on appetite and BMI. Results: Male and female parameters are serum albumin 3.7 ± 0.84/3.68.8 ± 0.81 g/dL, total protein 7.02 ± 1.27/6.94 ± 1.26 g/dL, creatinine 4.68 ± 4.19/3.74 ± 3.36 mg% creatinine clearance 33.22 ± 30.48/37.55 ± 33.87 ml/minute, BMI 22.60 ± 4.29/23.43 ± 4.77kg/m2 energy/kg 16.97 ± 0.65/16.8 ± 0.64, protein g/kg 0.65 ± 0.28/0.64 ± 0.30, carbohydrate g/kg 2.98 ± 1.54/2.98 ± 0.1.36, fat g/kg 2.98 ± 0.23/2.79 ± 0.22, respectively. As appetite decreased, dietary protein and energy intake decreased significantly. Appetite in males and females: Average 14.46%, 4.13%, poor 9.7%, 18.18%, anorexic 13.2%, 7.4%. Income had strong correlation with BMI (p 0.000), dietary protein (p 0.000), energy (p 0.000) and carbohydrate (p 0.000). Appetite correlated with creatinine (p 0.019), dietary energy, protein, carbohydrate and fat (p 0.000) intake. BMI correlated (p 0.000) with fat, carbohydrate, energy and creatinine clearance. ANOVA showed significant difference within and between appetite groups in energy, protein, fat, carbohydrate, creatinine clearance (p 0.000) and serum albumin (p 0.025). There was significant difference in protein (p 0.026), energy intake (p 0.000) and creatinine clearance (p 0.038) within and between BMI groups. Based on income, there was significant difference among groups in BMI (p 0.000), energy (p 0.019), protein (p 0.031) and albumin (0.001).展开更多
Background: The existence and prevalence of cerebral salt wasting and its differentiation from syndrome of inappropriate antidiuretic hormone have been controversial. This controversy stems from overlapping clinical a...Background: The existence and prevalence of cerebral salt wasting and its differentiation from syndrome of inappropriate antidiuretic hormone have been controversial. This controversy stems from overlapping clinical and laboratory findings and an inability to assess the volume status of these patients. Objectives:To present a case of a cerebral salt wasting syndrome secondary to a bacterial mengitis and to emphasize the difficulty to assess the diagnosis. Case report: A 51-year-old male admitted to the ICU for a severe bacterial meningitis who developed, four days later, hyponatremia associated with hypovolemia due to a renal salt wasting. Clinical and biological parameters were collected;electrolytes balances and salt clearances were calculated to best investigate this hydroelectrolytic disorder. Patient's volume status and improvement after fluid and sodium replacement highly suggests the diagnosis of a cerebral salt wasting syndrome. Conclusion: A thorough analysis of this case showed that occurrence of hyponatremia and renal salt wasting after brain agression is not univocal underlying the fact that the diagnosis of cerebral salt wasting should be assessed only after a careful examination of the different determinants of the hydroelectrolytical balance.展开更多
The purpose of the research was to obtain the mass wasting hazard map for the state of Vargas, central coast of Venezuela, using GIS technology. The work was developed through the heuristic method with the generation ...The purpose of the research was to obtain the mass wasting hazard map for the state of Vargas, central coast of Venezuela, using GIS technology. The work was developed through the heuristic method with the generation of thematic digital maps, univariate statistical treatment, weighting of each variable and quantifying the relationship of each parameter unit regarding mass wasting processes. The algorithm designed to perform map algebra was designed using the variables: surface geology, slope, slope orientation, terrain curvature, moisture topographic index, power index surface flow rate and capacity sediment transport and the rate normalized difference vegetation. The results show a distribution of landslide hazard with the highest values in the west central part of Vargas state, where the dominant lithology is incompetent, and combined with topographic elements, determining high instability, meanwhile the lower hazard areas were found in specific areas such as the middle watershed areas east of the state. The calibration of this model shows a reliability of 80%, so it is highly advisable to use the information generated in this work by governmental and non-governmental organizations in the planning, management and use of land.展开更多
<strong>Background:</strong> Malnutrition is a strong predictor of prognosis in maintenance hemodialysis patients (MHD). We previously proposed a new and simple protein-energy wasting (PEW) score that appe...<strong>Background:</strong> Malnutrition is a strong predictor of prognosis in maintenance hemodialysis patients (MHD). We previously proposed a new and simple protein-energy wasting (PEW) score that appears to be useful for assessing the risk of mortality in patients on MHD. <strong>Objectives: </strong>In the present study, we evaluated the reliability of this PEW score as a predictor of hospitalization in Japanese patients on MHD. <strong>Methods:</strong> In this single-center, prospective cohort study conducted in Japan, PEW score was calculated for 180 MHD patients. PEW score ranged from 0 (best: S1) to 4 (worst: S4) and was calculated based on nutritional indicators including serum albumin, body mass index, serum creatinine level, and protein intake. The outcome was the number of hospitalizations during the 2-year study period. <strong>Results:</strong> Thirty-six patients were hospitalized during the study period. Kaplan-Meier curves showed there were fewer hospitalizations in the group with a PEW score of 0/1 than in the group with a score of 3/4. Multivariate analysis revealed a hazard ratio for hospitalization of 3.109 for S3/4 versus S0, 2.777 for S3/4 versus S1, and 2.048 for S3/4 versus S2.<strong> Conclusion:</strong> The new and simple PEW score is a useful predictor of hospitalization in MHD patients and is also useful for identifying subgroups of MHD patients with a high risk of mortality.展开更多
Introduction: A higher risk of death is associated with wasting in children if it is not treated properly. The objective of this study was to investigate the ionic disorders observed in infants suffering from severe w...Introduction: A higher risk of death is associated with wasting in children if it is not treated properly. The objective of this study was to investigate the ionic disorders observed in infants suffering from severe wasting at Yalgado Ouedraogo Teaching Hospital (YO-TH) and at Charles de Gaulle Pediatric Teaching Hospital (CDG-PTH) in Ouagadougou (Burkina Faso). Methods: This was a retrospective study with a descriptive and analytical aim over the period from January 1, 2016 to December 31, 2020. Results: It concerned infants aged 6 to 24 months hospitalized at YO-TH and at CDG-PTH from Ouagadougou. We included 271 infants. The mean age of the infants was 14.48 ± 5.44 months with 42.07% which was in the age range of [12 - 18] months. On admission to the hospital, the children had an average weight, height and BMI of 6.22 ± 1.32 kg, 0.73 ± 0.07 m and 11.67 ± 1.53 kg/m<sup>2</sup>. In urban areas 56.46% of children and the main reasons for consultation were fever (88.19%), vomiting (52.80%) and diarrhea (50.20%). Electrolyte disturbances in emaciated infants affected all 8 parameters of the blood ionogram. However, the major disorders were 65.68% hyponatremia, 55.35% hypobicarbonatemia, 41.33% hypoprotidemia and 32.47% hypokalemia in infants aged 6 to 24 months. We found an association between diarrhea and residence with hypokalemia (p = 0.0000) and hypochloremia (p = 0.010), respectively. Conclusion: Severe acute wasting in infants 6 to 24 months of age remains a concern in the hospital setting. The frequency of biochemical disturbances is also high.展开更多
Research shows that workers drift from their contracted tasks to personal email,social networks and the far corners of the internet for anything between a few hours a week to a few hours a day.Six out of 10people admi...Research shows that workers drift from their contracted tasks to personal email,social networks and the far corners of the internet for anything between a few hours a week to a few hours a day.Six out of 10people admit they can’t get through the workday without checking their social media.展开更多
Background and Objectives:Protein-energy wasting(PEW)is common among maintenance hemodialysis(MHD)patients and is strongly associated with mortality and adverse outcomes.This study aimed to assess the effects of low-p...Background and Objectives:Protein-energy wasting(PEW)is common among maintenance hemodialysis(MHD)patients and is strongly associated with mortality and adverse outcomes.This study aimed to assess the effects of low-protein energy supplements on the nutritional status of MHD patients with PEW.Methods and Study Design:We conducted a prospective randomized controlled trial in 68 MHD patients suffering from PEW.Patients randomized to the intervention group received dietary counseling along with daily low-protein supplements containing 212 kcal of energy and 2.4 g of protein every day for 3 months.The control group received dietary counseling only.Dietary data,nutritional assessments,anthropometric measurements,bioelectrical impedance analysis and blood analysis were collected at baseline and after three months from both groups.Results:Fifty-nine MHD patients completed the study.Patients in the intervention group showed an increase in energy intakes(p<0.001).A significant decrease in the Malnutrition Inflammation Score(MIS)(p<0.001)and Nutrition Risk Screening 2002(p<0.001)were found in the intervention group compared with the control group.Moreover,significant improvements in mid-upper arm circumference(p<0.001),mid-arm muscle circumference(p<0.001),albumin(p=0.003),and prealbumin(p=0.033)were observed in the intervention group compared with the control group.Conclusions:The combination of oral low-protein supplements and dietary counseling for three months was more effective than dietary counseling alone in terms of improving the nutritional status of MHD patients with PEW.展开更多
Background and Objectives:Wasting among under-five years old(U-5)children is a significant global public-health-nutrition burden.To effectively address this problem in Bangladesh,knowing its prevalence,causes and asso...Background and Objectives:Wasting among under-five years old(U-5)children is a significant global public-health-nutrition burden.To effectively address this problem in Bangladesh,knowing its prevalence,causes and associated-factors are essential.This review aimed to identify evidences available in the existing-accessible litera ture/documents that describe the individual,socioeconomic,demographic,and contextual risk-factors associated with wasting among U-5 children in Bangladesh.Methods and S tudy Design:E lectronic-databases included were MEDLINE,EMBASE,CINAHL,WoS,and Cochrane-Library written in English and published until 29 February 2024.Results:The search from the five databases yielded 167 publications.Of these,50 papers/articles were duplicate s and 108 were irrelevant,and nine have met the inclusion criteria.Additionally,22 arti cles/documents were identified from other sources.Finally,a total of 31 articles/documents have been included in this review.The odds of childhood wasting observed were high for smaller birth-size,higher birth-order,male child,12-24 months age-group,improper breastfeeding-and complementary-feeding practices,not-receiving DPT1 and/or measles vaccine,≥1 sibling(s),maternal-undernutrition,less food-consumption during pregnancy,lack of maternal-education,lack of hand-washing practices by the mother/caregiver,paternal tobacco use,lower s ocioeconomic-status,food-insecurity,lack of access to hygienic-latrine and/or improved-water,Monsoon season(May-August),flood exposure,living especially in Barishal,Rajshahi Chittagong and Rangpur-division and/or Eastern part of Bangladesh,and urban-slum.Conclusions:The risk/associated factors of wasting among U-5 children in Bangladesh were found at various multilevel.Rarely caused by any one factor alone,wasting in U-5 children results from an interplay between pregnant-mother’s health and nutrition,child-caring practices,diets,poverty,and disease,which vary by context.展开更多
Background: Malnutrition, a serious public health concern, is influenced by various factors. Objective: The study aims to explore malnutrition issues among infants under five years old in Guéra Province. Methods:...Background: Malnutrition, a serious public health concern, is influenced by various factors. Objective: The study aims to explore malnutrition issues among infants under five years old in Guéra Province. Methods: The study used a cross-sectional design and a two-stage cluster sampling method to select participants. The study population was infants aged between 0 - 24 months. Data collection was done between June 2023 and September 2024;it included anthropometric measurements, blood analyses, and interviews. Anthropometric parameters were calculated using ENA for SMART software. Statistical analyses were performed by R Studio to investigate associations between different characteristics, using logistic regression models to identify risk factors. A p-value less than 0.05 was considered significant. Results: The study included 377 infants in eight villages in Guéra Province, Chad. The sample was predominantly girls (55.3%), with a median age of 16 months. Most infants (94%) were mixed-fed, and only 6% were exclusively breastfed. We found that 7.3% of children were globally malnourished, with higher rates in boys 9.6%. A significant disparity existed between boys and girls in global acute malnutrition (GAM) rates, with boys having a higher prevalence of 17.9%. A substantial proportion of Infants were underweight, with males 27.4%. Stunting was prevalent 20.1%. Several factors were associated with malnutrition, including gender, feeding practices, infectious diseases, and socioeconomic factors. Diarrhea, malaria, limited access to drinking water, and early diet diversification were significantly associated with malnutrition. Conclusion: Targeted interventions are necessary to address these issues and improve the nutritional status of children in the Guéra province.展开更多
Skeletal muscles perform important metabolic functions.Muscle mass wasting in sarcopenia is an urgent problem of modern medicine,the interest in which is related to its prognostic significance.The liver has numerous d...Skeletal muscles perform important metabolic functions.Muscle mass wasting in sarcopenia is an urgent problem of modern medicine,the interest in which is related to its prognostic significance.The liver has numerous direct and indirect metabolic and immune connections with skeletal muscle and disruptions of these connections in liver disease are of clinical interest.A recent article by Liang et al emphasized potential biomarkers of sarcopenia in liver cirrhosis.Identification of biomarkers of sarcopenia in patients with cirrhosis has important diagnostic value.Common pathophysiologic mechanisms of sarcopenia and liver cirrhosis include disorders of protein and energy metabolism,disturbances in the structure of gut microbiota,inflammation and oxidative stress.展开更多
BACKGROUND Chronic diarrhoea in people living with human immunodeficiency virus(PLHIV)/acquired immunodeficiency syndrome presents a diagnostic challenge,often resulting from opportunistic infections(OIs),malignancies...BACKGROUND Chronic diarrhoea in people living with human immunodeficiency virus(PLHIV)/acquired immunodeficiency syndrome presents a diagnostic challenge,often resulting from opportunistic infections(OIs),malignancies,or disease progression itself.We present a case of an advanced human immunodeficiency virus(HIV)patient with chronic diarrhoea,significant weight loss,and antiretroviral therapy(ART)non-compliance,highlighting the diagnostic dilemma between HIV wasting syndrome,OIs,and malignancy.CASE SUMMARY A 36-year-old female,diagnosed with HIV five years ago on family screening,presented with three months of profuse watery diarrhoea,associated with crampy abdominal pain and weight loss(14 kg,30%in 3 months).She was non-compliant with ART.There was no history of recent travel,food contamination,or tuberculosis contact.Fever episodes were mild and transient.Physical examination revealed pallor and bilateral pedal oedema without lymphadenopathy or organomegaly.Genital examination was unremarkable.Routine investigations revealed severe anaemia and confirmed PLHIV status.CD4 count was<36 cells/μL.Empirical treatment with nitazoxanide was initiated for possible cryptosporidiosis.After ruling out OIs,ART was restarted.With treatment,her diarrhoea resolved,and she tolerated oral intake.Nutritional support was provided,and she was discharged in stable condition with ART,prophylactic antibiotics,and followup instructions for further evaluation.CONCLUSION In ART-noncompliant PLHIV with chronic diarrhoea,distinguishing between HIV wasting syndrome,OIs(Cryptosporidium,Mycobacterium avium complex,cytomegalovirus colitis)and malignancies(non-Hodgkin lymphoma and anal carcinoma)are critical.Gradual CD4 decline,systemic inflammation,and malnutrition favour progressive HIV/acquired immunodeficiency syndrome rather than an acute OI or malignancy.Early recognition and management,including ART reinitiation and nutritional support,are crucial for prognosis.展开更多
基金supported by a grant from NIH(R01AI132695)to RM。
文摘Chronic wasting disease—a prion disease affecting cervids:Many neurological conditions,including Alzheimer's and Parkinson's diseases,amyotrophic lateral sclerosis,frontotemporal dementias,among others,are caused by the accumulation of misfolded proteins in the brain.These diseases affect not only humans,but also animals.
基金supported by the National Key Research and Development Program of China(Grant Nos.2021YFC3000401 and 2023YFS0435)the Science and Technology Research Program of the Institute of Mountain Hazards and Environment,Chinese Academy of Sciences(Grant No.IMHE-ZYTS-03)。
文摘Although the increase in the frequency of mass wasting events in the Sedongpu gully in recent years indicates that the Sedongpu gully has entered an intense mass wasting period,the current literature focuses only on ice‒rock avalanche events and lacks comprehensive knowledge of Sedongpu gully activity.To clarify the spatiotemporal distribution and scales of mass wasting events,we analysed multiple images from 1969 to present(including optical images and synthetic aperture radar(SAR)images)and topography data from 2013 to present.Since 1969,there have been at least 19 obvious mass wasting events that can be divided into 3 subpatterns:ice‒rock avalanches(IRAs,8 events),ice‒moraine avalanches(IMAs,2 events),and glacier debris flows(GDFs,9 events).Since 2017,the Sedongpu gully has entered the most active period,i.e.more than 68%of events occurred after 2017,and approximately 530 Mm^(3)and 185 Mm^(3)of materials were removed from mixtures of glacial and moraine(MGM)and glacial source areas(GSAs).Recent continuous warning states that the temperature of the Sedongpu gully area exceeded 0℃ from April to July 2012,and the 2017 Mw 6.4 Nyingchi earthquake was critical in the current intense erosion state.
基金funded in part by the Center on Emerging and Zoonotic Infectious Diseases(CEZID)of the National Institutes of General Medical Sciences underaward number P20GM130448.
文摘Transmissible spongiform encephalopathies(TSEs)are a group of progressive and ultimately fatal neurologic diseases of man and animals,all resulting from the propagated misfolding of the host's normal cellular prion protein.These diseases can be spontaneous,heritable,anthropogenic/iatrogenic,or in some cases horizontally transmissible,and include such notable TSEs as bovine spongiform encephalopathy(BSE)of cattle and chronic wasting disease(CWD)of cervids.Although they are both unequivocally protein misfolding disorders,they differ markedly in their pathogenesis,transmissibility,and zoonotic potential.While the BSE epidemic has largely abated over the past three decades following global feed bans on ruminant meat and bone meal,CWD,which is readily transmitted through various forms of excreta,has rapidly expanded from its original endemic zone to encompass much of North America,along with recently identified foci in Scandinavia.Most importantly,although the classical form of BSE has proven transmissible to humans consuming contaminated beef or beef products,so far there have been no conclusive reports on the zoonotic transmission of cWD to humans.The underlying basis for these differences-whether host or agent directed-are not well understood,though may be due to inherent differences in the three-dimensional structure of the misfolded BSE or CWD prion proteins or the expression levels and tissue distribution of respective cellular prion proteins.With the uncontrolled geographic spread of CWD,it is imperative that we improve our understanding of the factors governing prion disease pathogenesis,transmission,and zoonotic potential.
文摘Muscle wasting is defined as the progressive and generalized loss of muscle mass. Muscle depletion is a common feature of chronic liver disease foundin approximately 40% of patients with cirrhosis. Its etiology is multifactorial subsequent to liver failure and its prevalence increases along with disease severity. Cross-sectional analytic morphometry using computed tomography(CT) scan or magnetic resonance imaging are considered by consensus the gold standards to assess muscle size in cirrhosis for research purposes because they are not biased by fluid accumulation. Several studies have assessed the impact of muscle wasting on overall survival of patients in the waiting list for liver transplantation and there is a general agreement that decreased muscle size assessed by CT scan is an independent predictor for mortality in cirrhosis. It has been proposed that the addition of cross-sectional muscle area into the Model for End-stage Liver Disease can increase its prognostic performance. Nevertheless, the use of CT scan in assessing muscle size is inappropriate for routine clinical practice and an alternative cost-effective, easy to use and accurate tool should be developed. In conclusion, muscle wasting has a detrimental impact on survival of patients with cirrhosis and, thus, it remains to be elucidated if nutritional interventions and exercise could improve muscle wasting and, subsequently, survival in this setting.
基金Supported by The research project is implemented within the framework of the Action of the Operational Program "Education and Lifelong Learning"(Action’s Beneficiary:General Secretariat for Research and Technology)cofinanced by the European Social Fund(ESF)the Greek State
文摘Rheumatoid arthritis(RA), the commonest inflammatory arthritis, is a debilitating disease leading to functional and social disability. In addition to the joints, RA affects several other tissues of the body including the muscle. RA patients have significantly less muscle mass compared to the general population. Several theories have been proposed to explain this. High grade inflammation, a central component in the pathophysiology of the disease, has long been proposed as the key driver of muscle wasting. More recent findings however, indicate that inflammation on its own cannot fully explain the high prevalence of muscle wasting in RA. Thus, thecontribution of other potential confounders, such as nutrition and physical activity, has also been studied. Results indicate that they play a significant role in muscle wasting in RA, but again neither of these factors seems to be able to fully explain the condition. Oxidative stress is one of the major mechanisms thought to contribute to the development and progression of RA but its potential contribution to muscle wasting in these patients has received limited attention. Oxidative stress has been shown to promote muscle wasting in healthy populations and people with several chronic conditions. Moreover, all of the aforementioned potential contributors to muscle wasting in RA(i.e., inflammation, nutrition, and physical activity) may promote pro- or antioxidative mechanisms. This review aims to highlight the importance of oxidative stress as a driving mechanism for muscle wasting in RA and discusses potential interventions that may promote muscle regeneration via reduction in oxidative stress.
文摘The coexistence of different water homeostasis abnormalities following neurosurgery represents a diagnostic and therapeutic challenge for intensive care units. This paper reports the case of a 13 year-old boy who underwent surgery for a suprasellar tumour and, immediately after surgery, developed a cerebral abscess, persistent diabetes insipidus (DI) as well as cerebral salt wasting syndrome (CSWS). The early onset of CSWS following DI has been associated with a poor prognosis and increased mortality. In cases in which these abnormalities coexist, the increased polyuria secondary to the rise in natriuresis associated with CSWS might be erroneously interpreted as a sign of poor control of the DI, thereby leading to therapeutic mistakes. Treatment basically consists of restoring electrolytes and the joint administration of desmopressin and fludrocortisone.
文摘AIM To identify patients with end-stage renal disease treated by peritoneal dialysis(PD)who had zero body fat(BF)as determined by analysis of body composition using anthropometric formulas estimating body water(V)and to compare nutritional parameters between these patients and PD patients whose BF was above zero.METHODS Body weight(W)consists of fat-free mass(FFM)andBF.Anthropometric formulas for calculating V allow the calculation of FFM as V/0.73,where 0.73 is the water fraction of FFM at normal hydration.Wasting from loss of BF has adverse survival outcomes in PD.Advanced wasting was defined as zero BF when V/0.73 is equal to or exceeds W.This study,which analyzed 439 PD patients at their first clearance study,used the Watson formulas estimating V to identify patients with V_(Watson)/0.73≥W and compared their nutritional indices with those of PD patients with V_(Watson)/0.73<W.RESULTS The study identified at the first clearance study two male patients with V_(Watson)/0.73≥W among 439 patients on PD.Compared to 260 other male patients on PD,the two subjects with advanced wasting had exceptionally low body mass index and serum albumin concentration.The first of the two subjects also had very low values for serum creatinine concentration and total(in urine and spent peritoneal dialysate)creatinine excretion rate while the second subject had an elevated serum creatinine concentration and high creatinine excretion rate due,most probably,to non-compliance with the PD prescription.CONCLUSION Advanced wasting(zero BF)in PD patients,identified by the anthropometric formulas that estimate V,while rare,is associated with indices of poor somatic and visceral nutrition.
文摘Background Muscle wasting is a common clinical phenomenon that affects at least 20 percent of patients with heart failure. The exercise capacity of heart failure patients is limited; if left unchecked, which can form ca- chexia, seriously affecting the quality of life of patients with heart failure. This paper summarizes the clinical manifestations, pathophysiological mechanisms and its latest research direction including microRNA-regulated networks, and potential therapeutic strategies of muscle wasting in heart failure. Our goal is to provide a basis for clinicians to further understand and treat the muscle wasting in heart failure patients.
文摘The aim of the study is to monitor and assess landslide hazards by remote sensing data processing and GIS （Geographic Information Service） spatial analysis. Idukki district, the western Ghats of India was chosen as test area, because of frequent destructive mass wasting processes. Western Ghats is a prominent orographic feature that runs parallel to the south west coast of India. Predicting landslide hazard on a regional scale, namely the assessment of actual and potential mass movement over large area is carried out using Remote Sensing and GIS. A numerical weightage to the causative factors of slope instability such as slope, relative relief, aspect, curvature, drainage density, drainage frequency, land use, road buffer and drainage buffer are assigned as per earlier workers for the purpose of landslide susceptibility zonation. A high degree of match is found between observed and predicted landslide hazard by the procedure employed in the study.
文摘Protein energy wasting (PEW) is a major challenge in CKD. Objective: To assess PEW in predialysis patients on their first visit to a nephrologist. Methods: Three day dietary intake of 484 CKD stage 3 patients was taken. Appetite was assessed with ADAT. Patients were divided into groups based on appetite and BMI. Results: Male and female parameters are serum albumin 3.7 ± 0.84/3.68.8 ± 0.81 g/dL, total protein 7.02 ± 1.27/6.94 ± 1.26 g/dL, creatinine 4.68 ± 4.19/3.74 ± 3.36 mg% creatinine clearance 33.22 ± 30.48/37.55 ± 33.87 ml/minute, BMI 22.60 ± 4.29/23.43 ± 4.77kg/m2 energy/kg 16.97 ± 0.65/16.8 ± 0.64, protein g/kg 0.65 ± 0.28/0.64 ± 0.30, carbohydrate g/kg 2.98 ± 1.54/2.98 ± 0.1.36, fat g/kg 2.98 ± 0.23/2.79 ± 0.22, respectively. As appetite decreased, dietary protein and energy intake decreased significantly. Appetite in males and females: Average 14.46%, 4.13%, poor 9.7%, 18.18%, anorexic 13.2%, 7.4%. Income had strong correlation with BMI (p 0.000), dietary protein (p 0.000), energy (p 0.000) and carbohydrate (p 0.000). Appetite correlated with creatinine (p 0.019), dietary energy, protein, carbohydrate and fat (p 0.000) intake. BMI correlated (p 0.000) with fat, carbohydrate, energy and creatinine clearance. ANOVA showed significant difference within and between appetite groups in energy, protein, fat, carbohydrate, creatinine clearance (p 0.000) and serum albumin (p 0.025). There was significant difference in protein (p 0.026), energy intake (p 0.000) and creatinine clearance (p 0.038) within and between BMI groups. Based on income, there was significant difference among groups in BMI (p 0.000), energy (p 0.019), protein (p 0.031) and albumin (0.001).
文摘Background: The existence and prevalence of cerebral salt wasting and its differentiation from syndrome of inappropriate antidiuretic hormone have been controversial. This controversy stems from overlapping clinical and laboratory findings and an inability to assess the volume status of these patients. Objectives:To present a case of a cerebral salt wasting syndrome secondary to a bacterial mengitis and to emphasize the difficulty to assess the diagnosis. Case report: A 51-year-old male admitted to the ICU for a severe bacterial meningitis who developed, four days later, hyponatremia associated with hypovolemia due to a renal salt wasting. Clinical and biological parameters were collected;electrolytes balances and salt clearances were calculated to best investigate this hydroelectrolytic disorder. Patient's volume status and improvement after fluid and sodium replacement highly suggests the diagnosis of a cerebral salt wasting syndrome. Conclusion: A thorough analysis of this case showed that occurrence of hyponatremia and renal salt wasting after brain agression is not univocal underlying the fact that the diagnosis of cerebral salt wasting should be assessed only after a careful examination of the different determinants of the hydroelectrolytical balance.
文摘The purpose of the research was to obtain the mass wasting hazard map for the state of Vargas, central coast of Venezuela, using GIS technology. The work was developed through the heuristic method with the generation of thematic digital maps, univariate statistical treatment, weighting of each variable and quantifying the relationship of each parameter unit regarding mass wasting processes. The algorithm designed to perform map algebra was designed using the variables: surface geology, slope, slope orientation, terrain curvature, moisture topographic index, power index surface flow rate and capacity sediment transport and the rate normalized difference vegetation. The results show a distribution of landslide hazard with the highest values in the west central part of Vargas state, where the dominant lithology is incompetent, and combined with topographic elements, determining high instability, meanwhile the lower hazard areas were found in specific areas such as the middle watershed areas east of the state. The calibration of this model shows a reliability of 80%, so it is highly advisable to use the information generated in this work by governmental and non-governmental organizations in the planning, management and use of land.
文摘<strong>Background:</strong> Malnutrition is a strong predictor of prognosis in maintenance hemodialysis patients (MHD). We previously proposed a new and simple protein-energy wasting (PEW) score that appears to be useful for assessing the risk of mortality in patients on MHD. <strong>Objectives: </strong>In the present study, we evaluated the reliability of this PEW score as a predictor of hospitalization in Japanese patients on MHD. <strong>Methods:</strong> In this single-center, prospective cohort study conducted in Japan, PEW score was calculated for 180 MHD patients. PEW score ranged from 0 (best: S1) to 4 (worst: S4) and was calculated based on nutritional indicators including serum albumin, body mass index, serum creatinine level, and protein intake. The outcome was the number of hospitalizations during the 2-year study period. <strong>Results:</strong> Thirty-six patients were hospitalized during the study period. Kaplan-Meier curves showed there were fewer hospitalizations in the group with a PEW score of 0/1 than in the group with a score of 3/4. Multivariate analysis revealed a hazard ratio for hospitalization of 3.109 for S3/4 versus S0, 2.777 for S3/4 versus S1, and 2.048 for S3/4 versus S2.<strong> Conclusion:</strong> The new and simple PEW score is a useful predictor of hospitalization in MHD patients and is also useful for identifying subgroups of MHD patients with a high risk of mortality.
文摘Introduction: A higher risk of death is associated with wasting in children if it is not treated properly. The objective of this study was to investigate the ionic disorders observed in infants suffering from severe wasting at Yalgado Ouedraogo Teaching Hospital (YO-TH) and at Charles de Gaulle Pediatric Teaching Hospital (CDG-PTH) in Ouagadougou (Burkina Faso). Methods: This was a retrospective study with a descriptive and analytical aim over the period from January 1, 2016 to December 31, 2020. Results: It concerned infants aged 6 to 24 months hospitalized at YO-TH and at CDG-PTH from Ouagadougou. We included 271 infants. The mean age of the infants was 14.48 ± 5.44 months with 42.07% which was in the age range of [12 - 18] months. On admission to the hospital, the children had an average weight, height and BMI of 6.22 ± 1.32 kg, 0.73 ± 0.07 m and 11.67 ± 1.53 kg/m<sup>2</sup>. In urban areas 56.46% of children and the main reasons for consultation were fever (88.19%), vomiting (52.80%) and diarrhea (50.20%). Electrolyte disturbances in emaciated infants affected all 8 parameters of the blood ionogram. However, the major disorders were 65.68% hyponatremia, 55.35% hypobicarbonatemia, 41.33% hypoprotidemia and 32.47% hypokalemia in infants aged 6 to 24 months. We found an association between diarrhea and residence with hypokalemia (p = 0.0000) and hypochloremia (p = 0.010), respectively. Conclusion: Severe acute wasting in infants 6 to 24 months of age remains a concern in the hospital setting. The frequency of biochemical disturbances is also high.
文摘Research shows that workers drift from their contracted tasks to personal email,social networks and the far corners of the internet for anything between a few hours a week to a few hours a day.Six out of 10people admit they can’t get through the workday without checking their social media.
基金supported by the Scientific Research Start Plan of Shunde Hospital,Southern Medical University(SRSP2021003)the Foshan Medical Scientific Research Projects(20230351)+1 种基金the Medical Science and Technology Research Project of Foshan City(2320001006829)the Scientific Research Start Plan of Shunde Hospital,Southern Medical University(CRSP2022010).
文摘Background and Objectives:Protein-energy wasting(PEW)is common among maintenance hemodialysis(MHD)patients and is strongly associated with mortality and adverse outcomes.This study aimed to assess the effects of low-protein energy supplements on the nutritional status of MHD patients with PEW.Methods and Study Design:We conducted a prospective randomized controlled trial in 68 MHD patients suffering from PEW.Patients randomized to the intervention group received dietary counseling along with daily low-protein supplements containing 212 kcal of energy and 2.4 g of protein every day for 3 months.The control group received dietary counseling only.Dietary data,nutritional assessments,anthropometric measurements,bioelectrical impedance analysis and blood analysis were collected at baseline and after three months from both groups.Results:Fifty-nine MHD patients completed the study.Patients in the intervention group showed an increase in energy intakes(p<0.001).A significant decrease in the Malnutrition Inflammation Score(MIS)(p<0.001)and Nutrition Risk Screening 2002(p<0.001)were found in the intervention group compared with the control group.Moreover,significant improvements in mid-upper arm circumference(p<0.001),mid-arm muscle circumference(p<0.001),albumin(p=0.003),and prealbumin(p=0.033)were observed in the intervention group compared with the control group.Conclusions:The combination of oral low-protein supplements and dietary counseling for three months was more effective than dietary counseling alone in terms of improving the nutritional status of MHD patients with PEW.
基金funded by UNICEF under the grant num-ber GR-2155.
文摘Background and Objectives:Wasting among under-five years old(U-5)children is a significant global public-health-nutrition burden.To effectively address this problem in Bangladesh,knowing its prevalence,causes and associated-factors are essential.This review aimed to identify evidences available in the existing-accessible litera ture/documents that describe the individual,socioeconomic,demographic,and contextual risk-factors associated with wasting among U-5 children in Bangladesh.Methods and S tudy Design:E lectronic-databases included were MEDLINE,EMBASE,CINAHL,WoS,and Cochrane-Library written in English and published until 29 February 2024.Results:The search from the five databases yielded 167 publications.Of these,50 papers/articles were duplicate s and 108 were irrelevant,and nine have met the inclusion criteria.Additionally,22 arti cles/documents were identified from other sources.Finally,a total of 31 articles/documents have been included in this review.The odds of childhood wasting observed were high for smaller birth-size,higher birth-order,male child,12-24 months age-group,improper breastfeeding-and complementary-feeding practices,not-receiving DPT1 and/or measles vaccine,≥1 sibling(s),maternal-undernutrition,less food-consumption during pregnancy,lack of maternal-education,lack of hand-washing practices by the mother/caregiver,paternal tobacco use,lower s ocioeconomic-status,food-insecurity,lack of access to hygienic-latrine and/or improved-water,Monsoon season(May-August),flood exposure,living especially in Barishal,Rajshahi Chittagong and Rangpur-division and/or Eastern part of Bangladesh,and urban-slum.Conclusions:The risk/associated factors of wasting among U-5 children in Bangladesh were found at various multilevel.Rarely caused by any one factor alone,wasting in U-5 children results from an interplay between pregnant-mother’s health and nutrition,child-caring practices,diets,poverty,and disease,which vary by context.
文摘Background: Malnutrition, a serious public health concern, is influenced by various factors. Objective: The study aims to explore malnutrition issues among infants under five years old in Guéra Province. Methods: The study used a cross-sectional design and a two-stage cluster sampling method to select participants. The study population was infants aged between 0 - 24 months. Data collection was done between June 2023 and September 2024;it included anthropometric measurements, blood analyses, and interviews. Anthropometric parameters were calculated using ENA for SMART software. Statistical analyses were performed by R Studio to investigate associations between different characteristics, using logistic regression models to identify risk factors. A p-value less than 0.05 was considered significant. Results: The study included 377 infants in eight villages in Guéra Province, Chad. The sample was predominantly girls (55.3%), with a median age of 16 months. Most infants (94%) were mixed-fed, and only 6% were exclusively breastfed. We found that 7.3% of children were globally malnourished, with higher rates in boys 9.6%. A significant disparity existed between boys and girls in global acute malnutrition (GAM) rates, with boys having a higher prevalence of 17.9%. A substantial proportion of Infants were underweight, with males 27.4%. Stunting was prevalent 20.1%. Several factors were associated with malnutrition, including gender, feeding practices, infectious diseases, and socioeconomic factors. Diarrhea, malaria, limited access to drinking water, and early diet diversification were significantly associated with malnutrition. Conclusion: Targeted interventions are necessary to address these issues and improve the nutritional status of children in the Guéra province.
文摘Skeletal muscles perform important metabolic functions.Muscle mass wasting in sarcopenia is an urgent problem of modern medicine,the interest in which is related to its prognostic significance.The liver has numerous direct and indirect metabolic and immune connections with skeletal muscle and disruptions of these connections in liver disease are of clinical interest.A recent article by Liang et al emphasized potential biomarkers of sarcopenia in liver cirrhosis.Identification of biomarkers of sarcopenia in patients with cirrhosis has important diagnostic value.Common pathophysiologic mechanisms of sarcopenia and liver cirrhosis include disorders of protein and energy metabolism,disturbances in the structure of gut microbiota,inflammation and oxidative stress.
文摘BACKGROUND Chronic diarrhoea in people living with human immunodeficiency virus(PLHIV)/acquired immunodeficiency syndrome presents a diagnostic challenge,often resulting from opportunistic infections(OIs),malignancies,or disease progression itself.We present a case of an advanced human immunodeficiency virus(HIV)patient with chronic diarrhoea,significant weight loss,and antiretroviral therapy(ART)non-compliance,highlighting the diagnostic dilemma between HIV wasting syndrome,OIs,and malignancy.CASE SUMMARY A 36-year-old female,diagnosed with HIV five years ago on family screening,presented with three months of profuse watery diarrhoea,associated with crampy abdominal pain and weight loss(14 kg,30%in 3 months).She was non-compliant with ART.There was no history of recent travel,food contamination,or tuberculosis contact.Fever episodes were mild and transient.Physical examination revealed pallor and bilateral pedal oedema without lymphadenopathy or organomegaly.Genital examination was unremarkable.Routine investigations revealed severe anaemia and confirmed PLHIV status.CD4 count was<36 cells/μL.Empirical treatment with nitazoxanide was initiated for possible cryptosporidiosis.After ruling out OIs,ART was restarted.With treatment,her diarrhoea resolved,and she tolerated oral intake.Nutritional support was provided,and she was discharged in stable condition with ART,prophylactic antibiotics,and followup instructions for further evaluation.CONCLUSION In ART-noncompliant PLHIV with chronic diarrhoea,distinguishing between HIV wasting syndrome,OIs(Cryptosporidium,Mycobacterium avium complex,cytomegalovirus colitis)and malignancies(non-Hodgkin lymphoma and anal carcinoma)are critical.Gradual CD4 decline,systemic inflammation,and malnutrition favour progressive HIV/acquired immunodeficiency syndrome rather than an acute OI or malignancy.Early recognition and management,including ART reinitiation and nutritional support,are crucial for prognosis.
