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Cardiac Disease
Published in Praveen S. Goday, Cassandra L. S. Walia, Pediatric Nutrition for Dietitians, 2022
Megan Horsley, Jeffrey Anderson
An imbalance of metabolic supply and demand contributes to poor somatic growth in children with CHD. Often this imbalance is related to insufficient energy and protein intake, poor utilization or absorption of nutrients, increased expenditure, genetic predisposition, or a combination of the above. Hypermetabolism has been well described in CHD and may contribute to malnutrition and growth failure. Insufficient cardiac output or heart failure often leads to an increased metabolic demand given the body’s natural cascade of reactions in an effort to restore normal perfusion. A thorough nutrition assessment is required to determine nutrient intake, assess growth trends, and determine if adjustments are needed in the nutrition prescription and intervention.
Nutritional Complications of HIV Infection
Published in Fima Lifshitz, Childhood Nutrition, 2020
Progressive wasting is not an invariable consequence of AIDS. This was shown in a study of clinically stable patients, who were characterized by stable, moderate body cell mass depletion, normal caloric intake, mild-moderate malabsorption of sugars and fats, and hypometabolism.8 Other stages of the disease and active systemic disease complications are associated with hypermetabolism, however. Thus, wasting must be related to disease complications rather than to the underlying immune deficiency per se.
Unexplained Fever In Hematologic Disorders Section 1. Benign Hematologic Disorders
Published in Benedict Isaac, Serge Kernbaum, Michael Burke, Unexplained Fever, 2019
Other causes of lymphadenopathy — Dermatopathic lymphadenitis occurs in patients with exfoliative dermatitis. Lymphadenopathy may be present in hyperthyroidism, at times with splenomegaly as well. The manifestations of hypermetabolism are similar to those of lymphoma.
Application of beta-blockers in burn management
Published in Baylor University Medical Center Proceedings, 2022
Jonathan Kopel, Gregory L. Brower, Grant Sorensen, John Griswold
Several studies have evaluated interventions to counteract the adverse effects of hypermetabolism with regard to burn management and treatment. The current therapeutic approach evolved from clinical observations demonstrating that the increase in basal metabolic rate in burn patients results from catecholamine stimulation of beta-adrenergic receptors due to an elevated neuroendocrine response.1,10 The therapeutic use of beta-blockers to reduce the hypermetabolic response was subsequently championed by David Herndon and the burn team at the Shriners Burn Institute in Galveston, Texas. Several clinical trials have subsequently demonstrated that beta-adrenergic receptor blockade using propranolol is an effective intervention for reducing postburn catabolism and improving outcomes in severely burned patients.
Effect of Preoperative Nutritional Risk Screening and Enteral Nutrition Support in Accelerated Recovery after Resection for Esophageal Cancer
Published in Nutrition and Cancer, 2021
Yi Shen, Yunfeng Zhou, Tao He, Xiang Zhuang
Esophageal cancer is a common malignancy, and its main treatment is surgery-based comprehensive therapy. Patients often have malnutrition before surgery due to cancer-related metabolic consumption, digestive dysfunction, and mechanical esophageal obstruction, and postoperative hypermetabolism further aggravates malnutrition (8, 9). Many researchers recommend 7-10 day of preoperative nutrition support for patients with gastrointestinal tumors and malnutrition, which improves surgical tolerance and promotes postoperative recovery (2, 3). Garth et al. (10, 11) reported that malnutrition is closely related to postoperative complications in patients with esophageal cancer. Fujita et al. (12) showed that malnutrition can lead to impaired immunity after surgery, which increases the likelihood of pulmonary infection, wound infection, and anastomotic leakage. Jean et al. (4–6) found that preoperative malnutrition and a high NRS score increase the risk of postoperative complications, prolong the hospital stay, increase inpatient costs, and even increase the mortality rate. Moreover, some researchers believe that patients scheduled for digestive tract surgery benefit from preoperative nutritional assessment and nutritional intervention (7, 13). The European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines recommend early nutritional intervention in patients with nutritional risks (14). In short, risk screening and nutritional intervention play vital roles in postoperative recovery.
Dyslipidemia in patients with amyotrophic lateral sclerosis – a case control retrospective study
Published in Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 2021
Beata Chełstowska, Anna Barańczyk-Kuźma, Magdalena Kuźma-Kozakiewicz
Amyotrophic lateral sclerosis (ALS) is an incurable, devastating and fatal neurodegenerative disease of the central and peripheral nervous system (1,2). It is characterized by a progressive and selective loss of upper (UMN) and lower motor neurons (LMN) causing skeletal muscle weakness, paralysis, and death within 3–5 years from the first symptoms onset. Despite a large number of studies, pathogenesis of motor neurons degeneration is still unclear (3). Disturbances in glucose and lipid metabolism have been commonly observed in ALS patients indicating a global dysregulation of energy metabolism (4). Numerous ALS patients show increased energy expenditure or hypermetabolism (5) what is linked to loss of weight and shorter survival (6–9). The hypermetabolism results from regenerative effort in denervating muscles and/or an imbalance between food intake due to dysphagia and the amount of energy obtained from metabolic processes (4). It is also accompanied by dyslipidemia: up-regulation of both cholesterol (TCh) and low-density lipoproteins (LDLs) in CSF and plasma (10,11). Interestingly, an increased level of blood serum TCh, LDL, HDL, LDL/HDL ratio, and triacylglycerols (TAG) has been shown to positively correlate with prolonged survival in patients with ALS (4, 8), while lower levels of TCh, LDL, HDL/LDL and TAG were observed in patients with respiratory insufficiency (12–14). Since dyslipidemia is an important risk factor for cardiovascular diseases, it is not clear if it should be pharmacologically treated in patients with ALS.