1.Factors associated with stunting among infants and young children in the Fourth District of Camarines Sur, Philippines
Jeena Sandra R. Manrique-de hitta ; Kim Leonard G. Dela luna ; Anna Paulina S. Rodriguez ; Mildred O. Guirindola
Acta Medica Philippina 2025;59(9):62-71
OBJECTIVE
This study aimed to investigate the determinants linked to stunting among infants and young children aged 0-23 months in the Fourth District of Camarines Sur.
METHODSAn analytical cross-sectional study was conducted among 628 primary caregivers with infants and young children aged 0-23 months in four municipalities of the Fourth District of Camarines Sur, Philippines, using a two stage stratified random sampling design. Data on sociodemographic and economic factors were collected through face-to-face interviews. Infant and young child feeding (IYCF) indicators were assessed using a list-based approach, while weight and length were evaluated using the World Health Organization Anthro Plus software. Descriptive statistics and multiple logistic regression were done using R statistical software version 4.3.1.
RESULTSThe study revealed that the prevalence of stunting was of significant public health concern, reaching 42.8%. Holding other variables constant, age of the child (OR=0.77; 95% CI: 0.63-0.94), having college undergraduate mothers (OR=0.26; 95% CI: 0.05-1.28), and belonging to a poor income household (OR=0.40; 95% CI: 0.14-0.88) were associated with stunting among infants aged 0.01-6.00 months. Moreover, after controlling for the confounding effects of other variables, age (OR=1.09; 95% CI: 1.05-1.14) and sex of the child (OR=1.55; 95% CI: 1.05-2.28) were associated with stunting among older children aged 6.00-23.99 months.
CONCLUSIONThis study emphasizes the challenge of stunting in the Fourth District of Camarines Sur. None of the IYCF indicators were associated with stunting; however, maternal education, the child’s age, sex, and socioeconomic status were identified as significant factors influencing stunting. Addressing these determinants through targeted interventions focusing on improving maternal education and enhancing socio-economic conditions were crucial to reducing stunting in the study areas.
Human ; Growth Disorders ; Risk Factors ; Nutritional Status ; Infant Nutrition Disorders
3.Factors associated with stunting among infants and young children in the Fourth District of Camarines Sur, Philippines
Jeena Sandra R. Manrique-de Hitta ; Kim Leonard G. Dela luna ; Anna Paulina S. Rodriguez ; Mildred O. Guirindola
Acta Medica Philippina 2024;58(Early Access 2024):1-10
Objective:
This study aimed to investigate the determinants linked to stunting among infants and young children aged 0-23 months in the Fourth District of Camarines Sur.
Methods:
An analytical cross-sectional study was conducted among 628 primary caregivers with infants and young children aged 0-23 months in four municipalities of the Fourth District of Camarines Sur, Philippines, using a twostage stratified random sampling design. Data on sociodemographic and economic factors were collected through face-to-face interviews. Infant and young child feeding (IYCF) indicators were assessed using a list-based approach, while weight and length were evaluated using the World Health Organization Anthro Plus software. Descriptive statistics and multiple logistic regression were done using R statistical software version 4.3.1.
Results:
The study revealed that the prevalence of stunting was of significant public health concern, reaching 42.8%. Holding other variables constant, age of the child (OR=0.77; 95% CI: 0.63-0.94), having college undergraduate mothers (OR=0.26; 95% CI: 0.05-1.28), and belonging to a poor income household (OR=0.40; 95% CI: 0.14-0.88) were associated with stunting among infants aged 0.01-6.00 months. Moreover, after controlling for the confounding effects of other variables, age (OR=1.09; 95% CI: 1.05-1.14) and sex of the child (OR=1.55; 95% CI: 1.05-2.28) were associated with stunting among older children aged 6.00-23.99 months.
Conclusion
This study emphasizes the challenge of stunting in the Fourth District of Camarines Sur. None of the IYCF indicators were associated with stunting; however, maternal education, the child’s age, sex, and socioeconomic status were identified as significant factors influencing stunting. Addressing these determinants through targeted interventions focusing on improving maternal education and enhancing socio-economic conditions were crucial to reducing stunting in the study areas.
Human
;
growth disorders
;
risk factors
;
nutritional status
;
infant nutrition disorders
4.Pre-operative nutritional risk assessment using Malnutrition Universal Screening Tool (MUST) as a predictor of postoperative outcome in adult patients undergoing abdominopelvic surgery at a tertiary hospital in Iloilo – A prospective study
Catherine Rose P. Dumpit ; April Esther O. Caguimbay ; Sheila May P. Sonza-Zaragoza
Philippine Journal of Internal Medicine 2024;62(4):204-214
BACKGROUND
Several studies have shown the serious implications of malnutrition, yet it is still underestimated, understudied and an undertreated problem in hospitalized patients. It remains a challenge for hospitals in the Philippines. Pre operative malnutrition is a risk factor of perioperative morbidity and mortality. Thus, assessing the pre operative nutritional status is necessary in planning early nutritional interventions and may predict risk of developing postoperative complications.
METHODOLOGYA prospective cohort study was conducted among adult patients ages 18 to 70 years old admitted for abdominopelvic surgery at St. Paul’s Hospital Iloilo from January 2021 to January 2022. Within 24-48 hours of admission, patients’ demographic and clinical profiles were identified and the presence of nutritional risk was evaluated using the Malnutrition Universal Screening Tool (MUST). Further statistical analysis was done using cross tabulation, and Pearson’s chi-square and logistic regression.
RESULTSThe study demonstrated that nutritional risk, age, presence of malignancy, smoking and alcoholic beverage drinking were significantly correlated with post-operative complications.
CONCLUSIONNutritional risk screening using MUST pre-operatively can help predict the outcomes of post-operative patients undergoing abdominopelvic operation.
Human ; Nutrition Assessment
6.The association between heavy metal exposure and erectile dysfunction in the United States.
Wei WANG ; Li-Yuan XIANG ; Yu-Cheng MA ; Jia-Wei CHEN ; Liao PENG ; Xiao-Shuai GAO ; Fu-Xun ZHANG ; Yang XIONG ; Feng QIN ; Jiu-Hong YUAN
Asian Journal of Andrology 2023;25(2):271-276
Literature regarding the impacts of heavy metal exposure on erectile dysfunction (ED) is scarce. We aimed to evaluate the correlation between 10 urinary metals and ED in a large, nationally representative adult male sample. The dataset was extracted from the National Health and Nutrition Examination Survey (NHANES) during the period of 2001-2002 and 2003-2004. Weighted proportions and multivariable logistic regression analysis adjusted for confounding variables were utilized to determine the relationship between metal exposure and ED. Weighted quantile sum (WQS) regression was utilized to evaluate the impact of a mixture of urinary metals on ED. A total of 1328 participants were included in our study. In multivariable logistic regression analysis, cobalt (Co) and antimony (Sb) were positively associated with ED (odds ratio [OR]: 1.36, 95% confidence interval [CI]: 1.10-1.73, P = 0.020; and OR: 1.41, 95% CI: 1.12-1.77, P = 0.018, respectively) after full adjustment. Men in tertile 4 for Co (OR: 1.49, 95% CI: 1.02-2.41, P for trend = 0.012) and Sb (OR: 1.53, 95% CI: 1.08-2.40, P for trend = 0.041) had significantly higher odds of ED than those in tertile 1. Furthermore, the WQS index was significantly linked with increased odds of ED after full adjustment (OR: 1.31, 95% CI: 1.04-1.72, P < 0.05). Our study expanded on previous literature indicating the possible role of heavy metal exposure in the etiology of ED. The evaluation of heavy metal exposure should be included in the risk assessment of ED.
Adult
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Humans
;
Male
;
United States
;
Erectile Dysfunction/etiology*
;
Nutrition Surveys
;
Metals, Heavy
;
Risk Assessment
7.Pre-operative prognostic nutritional index as a predictive factor for prognosis in non-metastatic renal cell carcinoma treated with surgery.
Quan ZHANG ; Hai Feng SONG ; Bing Lei MA ; Zhe Nan ZHANG ; Chao Hui ZHOU ; Ao Lin LI ; Jun LIU ; Lei LIANG ; Shi Yu ZHU ; Qian ZHANG
Journal of Peking University(Health Sciences) 2023;55(1):149-155
OBJECTIVE:
To evaluate the implications of the prognostic nutrition index (PNI) in non-metastatic renal cell carcinoma (RCC) patients treated with surgery and to compare it with other hematological biomarkers, including neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and systemic immune inflammation index (SII).
METHODS:
A cohort of 328 non-metastatic RCC patients who received surgical treatment between 2010 and 2012 at Peking University First Hospital was analyzed retrospectively. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal cutoff values of the hematological biomarkers. The Youden index was maximum for PNI was value of 47.3. So we divided the patients into two groups (PNI≤ 47. 3 and >47. 3) for further analysis. Categorical variables [age, gender, body mass index (BMI), surgery type, histological subtype, necrosis, pathological T stage and tumor grade] were compared using the Chi-square test and Student' s t test. The association of the biomarkers with overall survival (OS) and disease-free survival (DFS) was analyzed using Kaplan-Meier methods with log-rank test, followed by multivariate Cox proportional hazards model.
RESULTS:
According to the maximum Youden index of ROC curve, the best cut-off value of PNI is 47. 3. Low level of PNI was significantly associated with older age, lower BMI and higher tumor pathological T stage (P < 0.05). Kaplan-Meier univariate analysis showed that lower PNI was significantly correlated with poor OS and DFS (P < 0.05). In addition, older age, lower BMI, tumor necrosis, higher tumor pathological T stage and Fuhrman grade were significantly correlated with poor OS (P < 0.05). Cox multivariate analysis showed that among the four hematological indexes, only PNI was an independent factor significantly associated with OS, whether as a continuous variable (HR=0.9, 95%CI=0.828-0.978, P=0.013) or a classified variable (HR=2.397, 95%CI=1.061-5.418, P=0.036).
CONCLUSION
Low PNI was a significant predictor for advanced pathological T stage, decreased OS, or DFS in non-metastatic RCC patients treated with surgery. In addition, PNI was superior to the other hematological biomar-kers as a useful tool for predicting prognosis of RCC in our study. It should be externally validated in future research before the PNI can be used widely as a predictor of RCC patients undergoing nephrectomy.
Humans
;
Prognosis
;
Nutrition Assessment
;
Carcinoma, Renal Cell/surgery*
;
Retrospective Studies
;
Biomarkers
;
Kidney Neoplasms/pathology*
8.Multiple portions enteral nutrition and chyme reinfusion of a blunt bowel injury patient with hyperbilirubinemia undergoing open abdomen: A case report.
Kai WANG ; Yun-Xuan DENG ; Kai-Wei LI ; Xin-Yu WANG ; Chao YANG ; Wei-Wei DING
Chinese Journal of Traumatology 2023;26(4):236-243
Blunt bowel injury (BBI) is relatively rare but life-threatening when delayed in surgical repair or anastomosis. Providing enteral nutrition (EN) in BBI patients with open abdomen after damage control surgery is challenging, especially for those with discontinuity of the bowel. Here, we report a 47-year-old male driver who was involved in a motor vehicle collision and developed ascites on post-trauma day 3. Emergency exploratory laparotomy at a local hospital revealed a complete rupture of the jejunum and then primary anastomosis was performed. Postoperatively, the patient was transferred to our trauma center for septic shock and hyperbilirubinemia. Following salvage resuscitation, damage control laparotomy with open abdomen was performed for abdominal sepsis, and a temporary double enterostomy (TDE) was created where the anastomosis was ruptured. Given the TDE and high risk of malnutrition, multiple portions EN were performed, including a proximal portion EN support through a nasogastric tube and a distal portion EN via a jejunal feeding tube. Besides, chyme delivered from the proximal portion of TDE was injected into the distal portion of TDE via a jejunal feeding tube. Hyperbilirubinemia was alleviated with the increase in chyme reinfusion. After 6 months of home EN and chyme reinfusion, the patient finally underwent TDE reversal and abdominal wall reconstruction and was discharged with a regular diet. For BBI patients with postoperative hyperbilirubinemia who underwent open abdomen, the combination of multiple portions EN and chyme reinfusion may be a feasible and safe option.
Male
;
Humans
;
Middle Aged
;
Enteral Nutrition
;
Intestines/surgery*
;
Intestinal Diseases
;
Abdomen/surgery*
;
Anastomosis, Surgical
;
Abdominal Injuries/surgery*
9.Association between early parenteral nutrition and the development of bronchopulmonary dysplasia in preterm infants.
Ru-Zheng XU ; Bin SUN ; Nai-Cheng ZHAO
Chinese Journal of Contemporary Pediatrics 2023;25(4):362-367
OBJECTIVES:
To study the relationship between early parenteral nutrient intake and the development of bronchopulmonary dysplasia (BPD) in preterm infants with gestational age less than 32 weeks who could not receive enteral nutrition within one week after birth.
METHODS:
A retrospective study was conducted on preterm infants born between October 2017 and August 2022 with gestational age less than 32 weeks who were admitted to the Neonatal Intensive Care Unit in Children's Hospital of Soochow University within 24 hours after birth and relied solely on parenteral nutrition within the first week of life. The study population included 79 infants with BPD and 73 infants without BPD. Clinical data during hospitalization were compared between the two groups.
RESULTS:
The proportions of infants with weight loss of more than 10% after birth, extrauterine growth retardation, and parenteral nutrition-associated cholestasis in the BPD group were higher than in the non-BPD group (P<0.05). The time to regain birth weight, time to achieve full enteral feeding, and corrected gestational age at discharge were longer in the BPD group than in the non-BPD group. The Z-scores of physical growth at corrected gestational age of 36 weeks were lower in the BPD group than in the non-BPD group (P<0.05). The BPD group had a higher fluid intake and a lower calories intake in the first week than the non-BPD group (P<0.05). The starting dose and total amount of amino acids, glucose, and lipids in the first week were lower in the BPD group than in the non-BPD group (P<0.05). The BPD group had a higher glucose-to-lipid ratio on the third day and higher energy-to-nitrogen and glucose-to-lipid ratios on the seventh day after birth than the non-BPD group (P<0.05).
CONCLUSIONS
Preterm infants with BPD had lower intake of amino acids and lipids and a lower proportion of calories provided by amino acids and lipids in the first week of life, which suggests an association between early parenteral nutrition intake and the development of BPD.
Infant
;
Child
;
Infant, Newborn
;
Humans
;
Infant, Premature
;
Bronchopulmonary Dysplasia/therapy*
;
Retrospective Studies
;
Gestational Age
;
Amino Acids
;
Parenteral Nutrition/adverse effects*
;
Glucose
;
Lipids
10.Value of the combined use of aminotransferase-to-platelet ratio index and total bile acid for predicting parenteral nutrition-associated cholestasis in preterm infants with gestational age <34 weeks.
Chinese Journal of Contemporary Pediatrics 2023;25(6):639-644
OBJECTIVES:
To explore the value of the combined use of aspartate aminotransferase-to-platelet ratio index (APRI) and total bile acid (TBA) for predicting parenteral nutrition-associated cholestasis (PNAC) in preterm infants with gestational age <34 weeks.
METHODS:
A retrospective analysis was performed on medical data of 270 preterm infants born at <34 weeks of gestation who received parenteral nutrition (PN) during hospitalization in the First Affiliated Hospital of Wannan Medical College from January 2019 to September 2022, including 128 infants with PNAC and 142 infants without PNAC. The medical data between the two groups were compared, and predictive factors for the development of PNAC were explored through multivariate logistic regression analysis. The receiver operating characteristic (ROC) curve was used to evaluate the value of APRI alone, TBA alone, and the combination of both for predicting PNAC.
RESULTS:
TBA levels in the PNAC group after 1, 2, and 3 weeks of PN were higher than those in the non-PNAC group (P<0.05). APRI in the PNAC group after 2 and 3 weeks of PN was higher than that in the non-PNAC group (P<0.05). Multivariate logistic regression analysis showed that elevated APRI and TBA after 2 weeks of PN were predictive factors for PNAC in preterm infants (P<0.05). ROC curve analysis showed that the sensitivity, specificity, and area under the curve (AUC) for predicting PNAC by combining APRI and TBA after 2 weeks of PN were 0.703, 0.803, and 0.806, respectively. The AUC for predicting PNAC by combining APRI and TBA was higher than that of APRI or TBA alone (P<0.05).
CONCLUSIONS
After 2 weeks of PN, the value of combining APRI and TBA for predicting PNAC is high in preterm infants with gestational age <34 weeks.
Infant, Newborn
;
Infant
;
Humans
;
Gestational Age
;
Infant, Premature
;
Retrospective Studies
;
Bile Acids and Salts
;
Parenteral Nutrition
;
Transaminases


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