Cerebral Palsy ; complications ; Child ; Child Nutrition Disorders ; complications ; Deglutition Disorders ; Equipment and Supplies ; Esophageal Motility Disorders ; etiology ; therapy ; Humans ; Speech Disorders ; etiology

Chronic obstructive pulmonary disease (COPD) is one of the major diseases worldwide. Nutritional depletion is a common problem in COPD patients and also an independant predictor of survival in these patients. Many data are helpful for determining nutritional depletion, including anthropometric measurement, laboratory markers, body composition analysis (fat-free mass and lean mass), and body weight. The mechanism of nutritional depletion in patients with COPD is still uncertain. It may be associated with energy/metabolism imbalance, tissue hypoxia, systemic inflammation, and leptin/orexin disorders. In patients with nutritional depletion, growth hormone and testosterone can be used for nutritional therapy in addition to nutrition supplementation.
Body Composition ; physiology ; Humans ; Intracellular Signaling Peptides and Proteins ; blood ; Leptin ; blood ; Lung Diseases, Obstructive ; blood ; complications ; Neuropeptides ; blood ; Nutrition Assessment ; Nutrition Disorders ; diagnosis ; etiology ; Orexins ; Weight Loss ; physiology

Age Factors ; Hepatitis Viruses ; Humans ; Liver Diseases, Alcoholic ; etiology ; Nutrition Disorders ; Polymorphism, Genetic ; Risk Factors ; Sex Factors

BACKGROUND/AIMS: Percutaneous endoscopic gastrostomy (PEG) is a method widely used for long-term enteral nutrition in dysphagia. Mostly, it is preceded by nasogastric intubation (NI) for short-term enteral nutrition; endoscopic findings associated with NI are encountered during PEG. The purpose of this study was to discuss such findings and to delineate a relationship between these findings, especially esophageal lesions and the duration of NI. METHODS: This study involved 185 individuals who had undergone PEG at Kyung Hee Medical Center from January 1999 to May 2002. The medical records were examined retrospectively. RESULTS: The dysfunction of the CNS comprised 98.4% of the causes of dysphagia. The duration of NI was 15.2 weeks on average, with median value of 8.7 weeks, indicating that PEG was performed relatively soon. Endoscopic findings revealed esophagitis in 63 cases, esophageal ulcers in 27 and active bleedings in another 10. The incidence of esophageal lesions was shown to be higher in subjects with duration of NI under 12 weeks than in those with duration over 12 weeks (p=0.032). CONCLUSIONS: PEG was carried out in many cases during the early stages of dysphagia, and NI-associated esophageal lesions appeared to be more prevalent within 12 weeks of NI duration. These results may be of help in deciding the timing of PEG.
Adult ; Aged ; Deglutition Disorders/therapy ; *Endoscopy, Gastrointestinal ; Enteral Nutrition ; Esophageal Diseases/*diagnosis/etiology ; Esophagus/*pathology ; Female ; *Gastrostomy ; Humans ; *Intubation, Gastrointestinal/adverse effects ; Male ; Middle Aged

Child ; Child Nutrition Sciences ; Child Nutritional Physiological Phenomena ; China ; Food Supply ; Growth Disorders ; epidemiology ; etiology ; prevention & control ; Humans ; Hygiene ; Malnutrition ; epidemiology ; Poverty ; Sanitation

Homocysteine ; analogs & derivatives ; blood ; Humans ; Infant ; Infant Nutrition Disorders ; complications ; Male ; Methylmalonic Acid ; urine ; Skin Diseases ; etiology ; Vitamin B 12 ; administration & dosage

Child ; Child Nutrition Disorders ; etiology ; physiopathology ; therapy ; Child Nutritional Physiological Phenomena ; Digestive System Diseases ; complications ; physiopathology ; Europe ; Gastroenterology ; Humans ; Nutritional Support ; Pediatrics

Leptin serves an important role in suppressing appetite in mice and is known to be elevated in chronic renal failure (CRF) patients. But clinical significance of leptin as an appetite-reducing uremic toxin, remains to be determined. So we studied the relationship between plasma leptin and nutritional status in 46 chronic hemodialysis (HD) patients. Pre HD leptin was measured and divided by body mass index (BMI) to give adjusted leptin levels. KT/Vurea (K, dialyzer urea clearance; T, duration of HD; V, volume of distribution of urea), C-reactive protein (CRP), plasma insulin and nutritional parameters such as serum albumin, normalized protein catabolic rate (nPCR), subjective global assessment (SGA), BMI and mid-arm muscle circumference (MAMC) were also measured. Mean plasma leptin levels were 8.13+/-2.91 ng/mL (male 3.15+/-0.70; female 14.07+/-6.14, p<0.05). Adjusted leptin levels were positively correlated with nPCR (male r=0.47, p<0.05; female r=0.46, p<0.05), SGA (male r=0.43, p<0.05; female r=0.51, p<0.05) and MAMC (male r=0.60, p<0.005; female r=0.61, p<0.05). They did not correlate with KT/Vurea, serum albumin, hematocrit, bicarbonate, insulin and CRP. Presence of DM and erythropoietin therapy had no effect on leptin levels. These results suggest that leptin is a marker of good nutritional status rather than a cause of protein energy malnutrition in chronic HD patients.
Adult ; Biological Markers/blood ; Cross-Sectional Studies ; Female ; Human ; Kidney Failure, Chronic/therapy ; Kidney Failure, Chronic/complications ; Kidney Failure, Chronic/blood* ; Leptin/blood* ; Male ; Middle Age ; Nutrition Disorders/etiology ; Nutrition Disorders/diagnosis ; Nutritional Status* ; Obesity/metabolism ; Obesity/etiology ; Renal Dialysis*/adverse effects ; Sex Factors

PURPOSE: The purposes of this study were to evaluate specific dysphagia patterns and to identify the factors affecting dysphagia, especially aspiration, following treatment of head and neck cancer. MATERIALS AND METHODS: A retrospective analysis of 57 patients was performed. Dysphagia was evaluated using a modified barium swallow (MBS) test. The MBS results were rated on the 8-point penetration-aspiration scale (PAS) and swallowing performance status (SPS) score. RESULTS: Reduced base of the tongue (BOT) retraction (64.9%), reduced laryngeal elevation (57.9%), and cricopharyngeus (CP) dysfunction (47.4%) were found. Reduced BOT retraction was correlated with clinical stage (p=0.011) and treatment modality (p=0.001). Aspiration in 42.1% and penetration in 33.3% of patients were observed. Twenty-four patients had PAS values over 6, implying aspiration. Forty-one patients had a SPS score of more than 3, 25 patients had a score greater than 5, and 13 patients had a SPS score of more than 7. Aspiration was found more often in patients with penetration (p=0.002) and in older patients (p=0.026). In older patients, abnormal swallowing caused aspiration even in those with a SPS score of more than 3, irrespective of stage or treatment, contrary to younger patients. Tube feeders (n=20) exhibited older age (65.0%), dysphagia/aspiration related structures (DARS) primaries (75.0%), higher stage disease (66.7%), and a history of radiotherapy (68.8%). CONCLUSION: Reduced BOT retraction was the most common dysphagia pattern and was correlated with clinical stage and treatment regimens including radiotherapy. Aspiration was more frequent in patients who had penetration and in older patients. In contrast to younger patients, older patients showed greater risk of aspiration even with a single abnormal swallowing irrespective of stage or treatment.
Adult ; Aged ; Aged, 80 and over ; *Barium Sulfate ; Combined Modality Therapy ; Contrast Media ; Deglutition ; *Deglutition Disorders/diagnosis/etiology/physiopathology ; Enteral Nutrition ; Female ; Head and Neck Neoplasms/complications/*radiotherapy ; Humans ; Male ; Middle Aged ; *Respiratory Aspiration/diagnosis/etiology/physiopathology ; Retrospective Studies

Ascorbic Acid ; administration & dosage ; Child ; Child Nutrition Disorders ; complications ; diet therapy ; Diagnosis, Differential ; Femoral Neoplasms ; diagnosis ; Femur ; diagnostic imaging ; Humans ; Male ; Protein-Energy Malnutrition ; complications ; diet therapy ; Radiography ; Scurvy ; diagnosis ; diet therapy ; etiology ; physiopathology ; Treatment Outcome