1/14. Gastrointestinal complications in a patient with eating disorders.eating disorders are frequently observed in young people. They can induce major complications involving several organs, either directly or through protein energy malnutrition. Gastrointestinal problems are the most common and somewhat different in restrictive and bulimic anorexia. Delayed gastric emptying prevails in restrictive anorexia, with slower intestinal transit and atrophy of the smooth muscles of the gastrointestinal tract. In bulimic anorexia, vomiting is the cause of several oesophageal and gastric lesions, from oesophagitis to perforation of the oesophagus or stomach. C.G. is a 16-year old boy who weighs 41.8 kg, is 174 cm tall and has a BMI 13.7 (kg/m2). At 14 he started to suffer from restrictive anorexia, then bulimic anorexia for the last two months. The day before admission, the patient ate a large quantity of "sfoglia-telle" in about 2 hours during a bulimic crisis. After 8 hours, he had spontaneous vomiting, malaise, abdominal tension and slight mental confusion. physical examination showed a tense and tender abdomen with infrequent peristalsis, mental confusion and dehydration. Laboratory evaluation confirmed dehydration (serum albumin 5.7 g/dL); a plain abdomen film showed marked gastrectasia. Instrumental examinations (abdominal CT scan, upper endoscopy) confirmed the diagnosis of gastrectasia with tight pyloric stenosis.- - - - - - - - - - ranking = 1keywords = malnutrition (Clic here for more details about this article) |
2/14. Neonatal hypernatraemic dehydration and malnutrition associated with inadequate breastfeeding and elevated breast milk sodium.The advantages of breastfeedng to both the mother and infant are well recognised. In rare instances if breasteding is inadequate or if the sodium content bast milk is high, malnutrition and hypernatraemia can result. A 15 days old exclusively breastfed baby presented with inadequate weight gain. On evaluation, he was found to have hypernatraemia and mother's breast milk showed high sodium concentrations. The infant needed parenteral fluid for correction of dehydration and hypernatraemia. His serum sodium and breast milk sodium of the other of the mother returned to normal gradually. He started gaining weight on exclusive breastfeeds. The present paper describes the case report and brief review of the literature.- - - - - - - - - - ranking = 5keywords = malnutrition (Clic here for more details about this article) |
3/14. A therapeutic approach to wean total parenteral nutrition in the management of short bowel syndrome: three cases using nocturnal enteral rehydration.short bowel syndrome is characterized by severe dehydration and malnutrition and requires total parenteral nutrition (TPN). Prolonged TPN has serious complications. Caloric requirements can be met orally but oral fluid replacement is problematic. Noncompliance and an inability to discontinue TPN earlier increase the likelihood of complications. Discontinuation of parenteral support requires an assessment of gastrointestinal anatomy and absorption capacity. Fluids must be replaced independently of feedings because the osmotic gradients decrease fluid absorption. Nocturnal enteral rehydration is an intervention using oral rehydration solutions through percutaneous endoscopic gastrostomy tubes at night. patients given nocturnal enteral rehydration discontinued TPN earlier and had improved fluid absorption.- - - - - - - - - - ranking = 1keywords = malnutrition (Clic here for more details about this article) |
4/14. stroke and seizure following a recent laparoscopic Roux-en-Y gastric bypass.Laparoscopic Roux-en-Y gastric bypass (LRYGBP) has been an available operation for weight loss for the past decade, and bariatric surgery is increasing in the united states. Careful patient screening and follow-up have been the cornerstone for success against the complexities of morbid obesity. Neurologic complications have occurred, such as polyneuropathy and Wernicke-korsakoff syndrome. We report an 18-year-old female with morbid obesity, steatohepatitis, tobacco, recreational drug, and oral contraceptive use who at 4 months after LRYGBP experienced a generalized seizure and stroke. She was diagnosed with an acute ischemic stroke, possibly venous infarction. Her postoperative course had been complicated by malnutrition and dehydration, apparently related to nausea from chronic cholecystitis. She had a possible protein-S deficiency. Rare neurologic complications emphasize the importance of postoperative surveillance in these patients.- - - - - - - - - - ranking = 1keywords = malnutrition (Clic here for more details about this article) |
5/14. Practical guide to intestinal rehabilitation for postresection intestinal failure: a case study.After massive small-intestinal resection or combined small-intestinal and colonic resection, diarrhea with resulting dehydration, electrolyte abnormalities, and malnutrition occur. Many patients become dependent on IV fluids and nutrition. An adaptation process manifested clinically by decreased diarrhea and improved nutrient absorption according to decreased parenteral nutrition and fluid requirements has been noted to occur over time. In some patients, adaptation is inadequate and may require special techniques to enhance and augment this process. This is a case of a 52-year-old woman who experienced increased stoma output 1 week after major intestinal resection, resulting in dehydration. She required IV fluids in order to maintain hydration. After the initiation of an intestinal rehabilitation program, which included modified diet, soluble fiber, oral rehydration solution (ORS), and medications, IV fluids were successfully weaned off in 3 months. She continues not to receive IV fluids and continues to follow the intestinal rehabilitation plan.- - - - - - - - - - ranking = 1keywords = malnutrition (Clic here for more details about this article) |
6/14. Malnutrition, a rare form of child abuse: diagnostic criteria.Infantile malnutrition is often difficult to diagnose as it is rarely observed in industrialized countries. It may be associated with physical violence or occur in isolation. The essential clinical sign is height and weight retardation, but malnutrition also causes a variety of internal and bone lesions, which lead to neuropsychological sequelae and death. We report a rare case of death by malnutrition in a female child aged 6 1/2 months. The infant presented height and weight growth retardation and internal lesions related to prolonged protein-energy malnutrition (fat and muscle wasting, thymic atrophy, liver steatosis) resulting in a picture of marasmus or kwashiorkor. We detail the positive and negative criteria that established the diagnosis of abuse, whereas the parents had claimed a simple dietary error.- - - - - - - - - - ranking = 4keywords = malnutrition (Clic here for more details about this article) |
7/14. methamphetamine use following bariatric surgery in an adolescent.bariatric surgery is increasingly popular as a therapeutic strategy for morbidly obese adolescents. Adolescence represents a sensitive period of psychosocial development, and children with considerable weight loss may experience greater peer acceptance, accompanied by both positive and negative influences. Substance abuse exists as one of these negative influences. We present the case of an adolescent bariatric surgical patient who abused methamphetamines in the postoperative period, with consequent nutritional instability. A concerted effort must be made in the preoperative assessment of adolescent bariatric patients to delineate a history of illicit drug use, including abuse of diet pills and stimulants. Excessive postoperative weight loss or micronutrient supplementation non-compliance should raise a suspicion of stimulant use and appropriate screening tests should be performed. The consequent appetite suppression may manifest with signs of malnutrition such as bradycardia, hypotension, and weakness. Inpatient nutritional rehabilitation and psychiatric assessment should be considered.- - - - - - - - - - ranking = 1keywords = malnutrition (Clic here for more details about this article) |
8/14. Management of hypernatremic dehydration due to insufficient lactation.Critical malnutrition and hypernatremic dehydration resulting from inadequate breast-feeding have previously been reported; the finding of elevated sodium concentration in expressed samples of mother's milk from these infants is found concurrently. This is the first case report describing successful relactation following management of hypernatremic dehydration in a breast-fed infant. Mother's milk was of inadequate volume and had a high sodium content. Treatment of the primary cause of this disorder, insufficient lactation, was effective in allowing successful relactation; a nursing supplementer is described.- - - - - - - - - - ranking = 1keywords = malnutrition (Clic here for more details about this article) |
9/14. A new diabetic with complications: primary nursing care.Martha, an elderly patient, presented a real challenge to our nursing staff. As a new diabetic, she needed a great deal of education in addition to extensive nursing care for her multiple bleeding leg ulcers, dehydration and malnutrition due to uncontrolled diabetes, and reactive depression. Despite these problems, in approximately one month's time Martha was able to return to her home in control of her diabetes and her emotions and ambulating without pain. Her successful return to normal life was enhanced by holistic nursing management. The nursing staff found that the use of a problem list and a diabetes educational plan assisted them in individualizing their patient care.- - - - - - - - - - ranking = 1keywords = malnutrition (Clic here for more details about this article) |
10/14. Effective use of total parenteral nutrition in an ileostomy patient.Several goals were achieved through nutritional support of a 52-year-old female ileostomy patient who was admitted with dehydration, clinical malnutrition of a kwashiorkor type, and excessive body fat. Initially, parenteral nutrition was used to stabilize the patient. A total parenteral nutrition solution was calculated to meet the patient's energy, protein, mineral, vitamin, and fluid needs, including special needs resulting from the loss of fluid and electrolytes via the ostomy. The patient was subsequently weaned onto enteral feeding and then onto food plus an enteral mineral and vitamin drip. nutritional status was improved (e.g., positive nitrogen balance was established); the patient absorbed nutrients better; and some lean body mass was restored, while total body weight decreased.- - - - - - - - - - ranking = 1keywords = malnutrition (Clic here for more details about this article) |
| | Next -> |