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Malnutrition
Published in Praveen S. Goday, Cassandra L. S. Walia, Pediatric Nutrition for Dietitians, 2022
Laura Gearman, Catherine Larson-Nath
Wasting and stunting are defined using z-scores. Wasting is defined as weight-for-height z-score less than −2. Stunting is defined as height-for-age z-scores less than less than −2. Wasting is usually a symptom of acute undernutrition, while stunting is seen as a result of chronic nutrition deprivation. Wasting and stunting in children are associated with health consequences. The severity of consequences is congruent with worsening z-scores.
Malignant Neoplasms
Published in Amy J. Litterini, Christopher M. Wilson, Physical Activity and Rehabilitation in Life-threatening Illness, 2021
Amy J. Litterini, Christopher M. Wilson
For individuals with advanced cancer, life expectancy varies widely based on the type, location, and extent of metastatic disease. For many, such as individuals with metastatic prostate cancer isolated to the skeleton, this can mean a prognosis of several years of survival. For others, such as those with metastatic spread to the liver, life expectancy often shortens to months. For these individuals, quality of life and maintaining functional mobility are key for the longest duration of time possible. Cachexia, or in the oncology setting cancer cachexia, is an unfortunate wasting condition that can occur with advanced disease. Please see Chapter 17 for information on cachexia.
Biochemistry of Exercise Training: Mitigation of Cancers
Published in Peter M. Tiidus, Rebecca E. K. MacPherson, Paul J. LeBlanc, Andrea R. Josse, The Routledge Handbook on Biochemistry of Exercise, 2020
Brittany R. Counts, Jessica L. Halle, James A. Carson
Cancer cachexia is a debilitating muscle wasting condition that occurs secondary to chronic disease (29). While 50% of all cancer patients will develop cachexia, it attributes to 20–40% of all cancer-related deaths (74). Consequences of cachexia are intolerance to anti-cancer therapy, susceptibility to treatment toxicity, and functional impairments that result in reduced patient life quality (28, 46). The progression of cachexia has been classified as a continuum (pre-cachexia to refractory cachexia), and a worse prognosis resulting in increased energy expenditure, insulin resistance, whole-body catabolism, and hypogonadism occurs with increasing severity (28, 74). Cachectic cancer patients exhibit reduced physical activity, exercise capacity, and muscular strength (35). Pre-clinical models of cancer cachexia also exhibit reduced cage activity, grip strength, and exercise capacity (35). Interestingly, in pre-clinical models of cachexia, voluntary activity declines prior to significant body weight loss, highlighting that decrements in activity might be an early indicator for cachexia's progression (7). Furthermore, physical inactivity that accompanies cachexia progression has been hypothesized to contribute to the condition's progression; therefore, ways to limit physical inactivity are of importance.
Pharmacological treatment options for heart failure with reduced ejection fraction: A 2022 update
Published in Expert Opinion on Pharmacotherapy, 2022
Kristian Hellenkamp, Kathleen Nolte, Stephan von Haehling
The list of comorbidities in HF that are of non-cardiovascular origin is a very long one. We already discussed the advent of SGLT2 inhibitors that was sparked by the EMPA-REG OUTCOME trial in 2015. Since safety data for most other drugs to treat diabetes in patients with HF are missing, recommendations in the ESC guidelines for treatment of diabetes remain very limited giving a clear preference for the SGLT2 inhibitors and metformin. Other comorbidities frequently encountered patients with HF embrace different clinical entities and body wasting. Skeletal muscle wasting, also known as sarcopenia, has been identified to have a significant impact on patients’ exercise capacity, [42] endothelial function [43], quality of life [44], and survival[45]. Overt weight loss, also known as cachexia, is like skeletal muscle wasting a clinical determinant of developing frailty in patients with HF and other cardiovascular illnesses. [46] The guideline discusses effective treatment strategies for muscle wasting that are currently limited to exercise training, possibly combined with a protein intake of 1–1.5 g/kg per day. Drug treatments had some beneficial effects in small clinical trials [47,48]. In this context it is interesting to acknowledge that the etiology of HF does not seem to have a major influence on changes in body composition, e.g. when patients with Chagas disease and HF and those with ischemic HF were compared, the percentage of patients affected by sarcopenia was equal between groups. However, Chagas disease and HF showed a tendency toward a greater reduction in total lean body mass[49].
Tuberculosis in children with severe acute malnutrition
Published in Expert Review of Respiratory Medicine, 2022
Bryan J Vonasek, Kendra K Radtke, Paula Vaz, W Chris Buck, Chishala Chabala, Eric D McCollum, Olivier Marcy, Elizabeth Fitzgerald, Alexander Kondwani, Anthony J Garcia-Prats
According to the WHO, there were an estimated 10 million incident TB cases worldwide in 2019. Children <15 years of age represented 12% of incident cases but 16% of the estimated 1 · 4 million deaths from TB [9]. Mathematical modeling suggests that of the children <15 years of age that die of TB, 80% are <5 years of age [10]. Global and regional estimates of the burden of SAM are limited by inconsistent definitions and underreporting, with the epidemiology of edematous SAM, or kwashiorkor, particularly poorly defined [11]. Severe wasting (WLHZ less than −3) affects an estimated 16 · 6 million children under the age of 5 years worldwide [12]. Severe wasting has a hazard ratio of 11 · 6 (95% confidence interval, CI: 9 · 8 to 13 · 8) for mortality compared to a reference category of WHLZ −1 or greater [13]. Global deaths attributable to severe wasting for children under the age of five in 2011 were estimated at 516,000 [14].
Is It “Aging” or Immunosenescence? The COVID-19 Biopsychosocial Risk Factors Aggravating Immunosenescence as Another Risk Factor of the Morbus. A Developmental-clinical Social Work Perspective
Published in Journal of Gerontological Social Work, 2021
Robert K. Chigangaidze, Patience Chinyenze
Malnutrition in all its forms has become the leading cause of ill health and death, and the rapid rise of diet-related NCDs in straining the health systems (Development Initiatives, 2020). Malnutrition is prevalent among approximately one-third of the elderly, especially in those with institutionalized facilities (Sciacqua et al., 2020). Malnutrition in the early ages of life has been implicated in the development of NCDs in later ages of life (World Health Organization, 2014) contributing to weakening of the immune system. This aggravates one’s predisposition to developing complications when infected with COVID-19 (Chigangaidze, 2020). Malnutrition is a major geriatric syndrome due to multifaceted etiology, characterized by muscle wasting and weight loss, which is strongly related to frailty and negative outcomes (Bencivenga et al., 2020). COVID-19 has also affected the access to food by the elderly due to lockdowns (Cohen & Tavares, 2020; Miller, 2020).