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Preparing the Malnourished Patient for Parenteral Nutrition (PN)
Published in Michael M. Rothkopf, Jennifer C. Johnson, Optimizing Metabolic Status for the Hospitalized Patient, 2023
Michael M. Rothkopf, Jennifer C. Johnson
The GIs were later astounded that some of the camp survivors collapsed and died after eating. Why did this happen? It was refeeding syndrome (Hearing 2004). The sudden ingestion of glucose in a starved individual created rapid shifts in extracellular ions and micronutrients, leading to a life-threatening imbalance (Mehanna, Moledina, and Travis 2008). Refeeding syndrome has since been reported in other starvation or near-starvation conditions, including anorexia nervosa and disaster victims (Walmsley 2013).
Assessment – Macronutrient Needs and Oral Intake
Published in Jennifer Doley, Mary J. Marian, Adult Malnutrition, 2023
Conversely, metabolism in a malnourished individual, or one at risk of malnutrition, may differ considerably from healthy individuals. Malnutrition can occur in states of chronic disease, starvation or acute inflammation, and macronutrient metabolism differs between these conditions. Although several diagnostic guidelines for malnutrition have been published, the most recent and widely accepted guidelines, from the American Society of Parenteral and Enteral Nutrition (ASPEN) / Academy of Nutrition and Dietetics (Academy) and the Global Leadership Initiative on Malnutrition, are etiology-based.4,5 Etiology of malnutrition is generally categorized based on the degree and duration of inflammation. The exception is starvation-related malnutrition, in which inflammation does not play a role. Chronic disease-related malnutrition refers to a prolonged state of inflammation of mild to moderate degree that is caused by a chronic disease such as organ dysfunction or failure.4 Chronic conditions are defined as those existing for three months or longer. Acute illness-related malnutrition is defined as a severe and more rapid-onset inflammation due to trauma or injury, such as that caused by burns or a head injury.4 The body prioritizes macronutrient metabolism and preservation of lean body mass (LBM), depending on the level of inflammation and severity of disease.4 The following sections describe metabolism in individuals in starvation states, and those with chronic and acute disease.
Case 15
Published in Andrew Solomon, Julia Anstey, Liora Wittner, Priti Dutta, Clinical Cases, 2021
Andrew Solomon, Julia Anstey, Liora Wittner, Priti Dutta
Refeeding syndrome is when potentially dangerous shifts occur in the levels of fluids and electrolytes in patients when feeding is restarted after malabsorption or starvation. It is most common in patients receiving some form of artificial feed, but it can also occur with oral feeding, particularly if the patient is receiving nutritional supplements. The risk is increased with any cause of malabsorption.
Does Home Oral Nutritional Support Improve Nutritional Status and Quality of Life following Colorectal Cancer Surgery?
Published in Nutrition and Cancer, 2022
Bilal Arslan, Tahsin Çolak, Ahmet Dağ
Most studies generally evaluated the nutritional status in the short term of 4 weeks or 8 weeks postoperatively. However, a study conducted by Beattie AH et al. suggested that patients with malnutrition began to gain weight after six weeks postoperatively at the earliest (29). Besides, semi-starvation causes fatigue, muscle pain, depression, apathy, mental stagnation, and lack of concentration in young, healthy people. It takes at least six months for all of these to return to normal and for the patient to fully recover (30). Therefore, it has been found that initiation of ONS in the early period after discharge has positive effects on patients (31, 32). However, it has been suggested in some studies that patient compliance with ONS at home is low (2, 33). In our clinical practice, ONS was planned for 6 mo, in patients who had undergone complex colorectal surgery.
Effects of 1800 MHz radiofrequency fields on signal transduction and antioxidant proteins in human A172 glioblastoma cells
Published in International Journal of Radiation Biology, 2021
James P. McNamee, Veronica S. Grybas, Sami S. Qutob, Pascale V. Bellier
While the current study assessed a large number of antioxidant and signal transduction proteins simultaneously at multiple time-points after both continuous-wave and GSM-modulated 1800 MHz RF-EMF exposure, it is possible that the exposure times chosen were not ideal for the detection of effects. Future studies should consider assessing a wide range of exposure times to further investigate this aspect. Furthermore, while consistent changes in either antioxidant or ST proteins were not observed in the current study, subtle but biologically meaningful changes in response cannot be ruled out. Indeed, there was a general tendency for decreased expression of antioxidant proteins and increased expression of the phosphorylated signal transduction proteins. The consequences of such small fold changes on cellular and human health is unknown. It is not clear how serum starvation affected the general outcome of this study, as no consistent effects were observed across the endpoints studied. While changes were observed between the serum-containing and serum-free cultures, the degree of effect varied and was dependant on the pathway studied, similar to the observations of Pirkmajer and Chibalin (2011).
Urban homelessness and baseras/shelters: an evaluative study conducted during winter in NCT Delhi
Published in Journal of Social Distress and Homelessness, 2020
Shankey Verma, Vartika Srivastava
Starvation is the characteristic of some people not having enough food to eat. It is not the characteristic of there being not enough food to eat … Starvation is a function of entitlements and not of food availability as such. (Sen, 1981, p. 1) Fasting is the first step of starvation. A proper diet gives strength to fight infections, diseases and weather extremities. Eating enough food three times a day is a luxury to many living inside the shelter homes. The fate is decided by the earnings. Many who do not earn enough look for charity outside, beg near temples or crowded markets, eat from langars (community kitchen), or if they get lucky, leftovers are dropped by some philanthropist or hotel owners at the night shelters. Starvation remains the last option and the ugliest. Commissioners of the Supreme Court (2014) also reiterated that severe malnutrition and hunger were the underlying causes making people susceptible to extreme weather conditions.