Wasting Syndrome

浪费综合征
  • 文章类型: Journal Article
    目的:在5岁以下(U-5)儿童中浪费是一个重大的全球公共卫生营养负担。为了有效解决孟加拉国的这一问题,知道它的流行,原因和相关因素是必不可少的。这篇综述旨在确定现有的描述个人的文献/文件中可用的证据,社会经济,人口统计学,以及与孟加拉国U-5儿童消瘦相关的背景风险因素。
    方法:电子数据库包括MEDLINE,EMBASE,CINAHL,WOS,和Cochrane-Library用英文编写,出版至2024年2月29日。
    结果:从五个数据库中检索出167种出版物。其中,50篇论文/文章是重复的,108篇是无关紧要的,九人符合入选标准。此外,从其他来源确定了22篇文章/文件。最后,这次审查共包括31篇文章/文件。对于较小的出生尺寸,观察到的儿童消瘦的可能性很高,较高的出生顺序,男孩,12-24月龄组,不适当的母乳喂养和补充喂养做法,不接受DPT1和/或麻疹疫苗,≥1个兄弟姐妹,产妇营养不良,怀孕期间减少食物消耗,缺乏母亲教育,母亲/照顾者缺乏洗手习惯,父亲使用烟草,较低的社会经济地位,粮食不安全,无法获得卫生厕所和/或改良水,季风季节(5月至8月),洪水暴露,特别是生活在巴里沙尔,拉杰沙希吉大港和朗普尔分部和/或孟加拉国东部,和城市贫民窟。
    结论:孟加拉国U-5儿童消瘦的风险/相关因素存在于不同的多层次。很少由任何一个因素单独引起,U-5儿童的浪费是由于孕妇的健康和营养之间的相互作用,照顾儿童的做法,饮食,贫穷,和疾病,因上下文而异。
    OBJECTIVE: Wasting among under-five years old (U-5) children is a significant global public-health-nutrition burden. To effectively address this problem in Bangladesh, knowing its prevalence, caus-es and associated-factors are essential. This review aimed to identify evidences available in the existing-accessible literature/documents that describe the individual, socioeconomic, demographic, and contextual risk-factors associated with wasting among U-5 children in Bangladesh.
    METHODS: Electronic-databases included were MEDLINE, EMBASE, CINAHL, WoS, and Cochrane-Library written in English and published until 29 February 2024.
    RESULTS: The search from the five databases yielded 167 publications. Of these, 50 papers/articles were duplicates and 108 were irrelevant, and nine have met the inclusion criteria. Additionally, 22 articles/documents were identified from other sources. Finally, a total of 31 articles/documents have been included in this review. The odds of childhood wasting observed were high for smaller birth-size, higher birth-order, male child, 12-24 months age-group, improper breastfeeding- and complementary-feeding practices, not-receiving DPT1 and/or measles vaccine, ≥1 sibling(s), maternal-undernutrition, less food-consumption during pregnancy, lack of maternal-education, lack of hand-washing practices by the mother/caregiver, paternal tobacco use, lower socioeconomic-status, food-insecurity, lack of access to hygienic-latrine and/or improved-water, Monsoon season (May-August), flood exposure, living es-pecially in Barishal, Rajshahi Chittagong and Rangpur-division and/or Eastern part of Bangladesh, and urban-slum.
    CONCLUSIONS: The risk/associated factors of wasting among U-5 children in Bangladesh were found at various multilevel. Rarely caused by any one factor alone, wasting in U-5 children results from an interplay between pregnant-mother\'s health and nutrition, child-caring practices, diets, poverty, and disease, which vary by context.
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  • 文章类型: Journal Article
    背景:营养不良,包括发育迟缓,浪费,体重不足,是一个全球性的问题,特别是低收入和中等收入国家的儿童。据我们所知,这项研究首次来自阿富汗。其主要目标是估计发育迟缓的患病率和相关风险因素,浪费/瘦身,阿富汗坎大哈市城市小学生体重不足。
    方法:这项基于学校的横断面研究是在6个月(2022年10月至2023年3月)期间对1205名6-12岁的小学生进行的。从所有参与者收集人体测量和其他数据。数据采用描述性统计分析,卡方检验(使用粗比值比或COR),和多变量逻辑回归(使用调整后的比值比或AOR)。
    结果:在1205名注册的政府学校学生中,47.4%,19.5%,25.6%发育迟缓,浪费/瘦身,体重不足,分别。与发育迟缓相关的统计学显著因素是6-9岁年龄组(AOR1.3,95%CI1.1-1.7),作为女孩(AOR2.3,95%CI1.8-3.0),贫困(AOR2.2,95%CI1.5-3.2),大家族(AOR3.0,95%CI2.4-3.9),文盲母亲(AOR1.6,95%CI1.0-2.6),失业的家庭户主(AOR3.3,95%CI2.3-4.8),和不吃早餐(AOR1.7,95%CI1.2-2.3)。与消瘦相关的主要因素是6-9岁年龄组(AOR30.5,95%CI11.8-78.7),跳过早餐(AOR22.9,95%CI13.9-37.8),过去两周的病史(AOR17.0,95%CI6.6-43.8)。此外,与体重不足相关的主要因素是6-9岁年龄组(AOR2.6,95%CI1.6-4.1),跳过早餐(AOR2.6,95%CI1.8-3.6),卫生条件差(AOR1.9,95%CI1.1-3.2)。
    结论:发育迟缓,浪费/瘦身,和体重不足在坎大哈市的小学生(包括男孩和女孩)中非常普遍。建议地方政府(阿富汗教育部和公共卫生部)在国际组织和捐助机构的帮助下,实施全面的学校供餐方案,特别是针对女孩的方案。应开展健康和营养教育计划,重点是6-9岁儿童的营养,以及健康早餐和良好卫生条件的重要性。
    BACKGROUND: Undernutrition, which includes stunting, wasting, and underweight, is a global problem, especially among children of low- and middle-income countries. To our knowledge, this study is first of its type from Afghanistan. Its main objectives were to estimate the prevalence and associated risk factors of stunting, wasting/thinness, and underweight among urban primary school children in Kandahar city of Afghanistan.
    METHODS: This school-based cross-sectional study was conducted among 1205 primary school children aged 6-12 years during a period of six months (October 2022-March 2023). Anthropometric measurements and other data were collected from all the participants. Data were analyzed by using descriptive statistics, Chi square test (using crude odds ratio or COR), and multivariate logistic regression (using adjusted odds ratio or AOR).
    RESULTS: Among the 1205 enrolled government school students, 47.4%, 19.5%, and 25.6% had stunting, wasting/thinness, and underweight, respectively. Statistically significant factors associated with stunting were age group 6-9 years (AOR 1.3, 95% CI 1.1-1.7), being girl (AOR 2.3, 95% CI 1.8-3.0), poverty (AOR 2.2, 95% CI 1.5-3.2), large family (AOR 3.0, 95% CI 2.4-3.9), illiterate mother (AOR 1.6, 95% CI 1.0-2.6), jobless head of the family (AOR 3.3, 95% CI 2.3-4.8), and skipping breakfasts (AOR 1.7, 95% CI 1.2-2.3). Main factor associated with wasting/thinness were age group 6-9 years (AOR 30.5, 95% CI 11.8-78.7), skipping breakfasts (AOR 22.9, 95% CI 13.9-37.8), and history of sickness during the past two weeks (AOR 17.0, 95% CI 6.6-43.8). Also, main factors associated with underweight were age group 6-9 years (AOR 2.6, 95% CI 1.6-4.1), skipping breakfasts (AOR 2.6, 95% CI 1.8-3.6), and poor sanitation (AOR 1.9, 95% CI 1.1-3.2).
    CONCLUSIONS: Stunting, wasting/thinness, and underweight are highly prevalent among primary school children (both girls and boys) in Kandahar city. It is recommended that local government (Afghanistan Ministry of Education and Ministry of Public Health) with the help of international organizations and donor agencies should implement comprehensive school-based feeding programs especially for girls. Health and nutrition education programs should be conducted with emphasis on nutrition of children aged 6-9 years as well as importance of healthy breakfast and good sanitation.
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  • 文章类型: Journal Article
    目的:本研究旨在发现喀布尔6-36个月儿童营养不良的分布和相关因素。
    方法:横断面研究。
    方法:阿塔图尔克公立儿童医院,喀布尔。
    方法:385。
    方法:使用结构化问卷收集有关儿童社会人口状况和人体测量学的数据。使用Logistic回归来寻找营养不足的决定因素。
    结果:发育迟缓的分布,消瘦和体重不足为38.7%,11.9%和30.6%,分别。在研究的孩子中,54%的人在出生后的第一个小时内没有接受母乳,53.2%不是纯母乳喂养,21%的人在6个月大之前接受了补充喂养,22.1%的人无法获得安全的水,44.7%的人没有用肥皂洗手。女孩发育迟缓的几率较低(p<0.05)(AOR5.511,95%CI3.028至10.030),受过教育的父亲的子女(OR0.288,95%CI0.106至0.782),核心家庭(OR0.280,95%CI0.117至1.258),纯母乳喂养者(OR0.499,95%CI0.222至1.51)和良好卫生习惯者(OR0.440,95%CI0.229至0.847)。男孩女孩的奇数较高(OR6.824,95%CI3.543至13.143),而受过教育的父亲的孩子(OR0.340,95%CI0.119至0.973),6个月时接受辅食的患者(OR0.368,95%CI0.148~1.393)和卫生习惯良好的患者(OR0.310,95%CI0.153~0.631)体重过轻的几率较低(p<0.05).男孩(OR3.702,95%CI1.537至8.916)被浪费的几率更高,而受过教育的母亲的孩子(OR0.480,95%CI0.319至4.660),核心家庭(OR0.356,95%CI0.113至1.117),早期母乳喂养(OR0.435,95%CI0.210~1.341)和洗手(OR0.290,95%CI0.112~0.750)的患者浪费的几率较低(p<0.05).
    结论:这项研究证明了孩子的性别,父亲的文盲,不洗手,不遵守卫生,晚期开始母乳,补充喂食时间,以及缺乏适当的纯母乳喂养是导致研究人群中儿童营养不良的因素。
    OBJECTIVE: The current study aimed to find the distribution and factors associated with undernutrition among children aged 6-36 months in Kabul.
    METHODS: Cross-sectional study.
    METHODS: Public Ataturk Children\'s Hospital, Kabul.
    METHODS: 385.
    METHODS: A structured questionnaire was used to collect data on sociodemographic conditions and anthropometry of children. Logistic regression was used to find determinants of undernutrition.
    RESULTS: The distribution of stunting, wasting and underweight was 38.7%, 11.9% and 30.6%, respectively. Among the children studied, 54% did not receive breast milk within the first hour of birth, 53.2% were not exclusively breastfed, 21% received complementary feeding before the age of 6 months, 22.1% lacked access to safe water and 44.7% did not practise hand washing with soap. The odds of stunting were lower (p<0.05) in girls (AOR 5.511, 95% CI 3.028 to 10.030), children of educated fathers (OR 0.288, 95% CI 0.106 to 0.782), those from nuclear families (OR 0.280, 95% CI 0.117 to 1.258), those exclusively breastfed (OR 0.499, 95% CI 0.222 to 1.51) and those practising good hygienic practices (OR 0.440, 95% CI 0.229 to 0.847). Boys had high odd of girls (OR 6.824, 95% CI 3.543 to 13.143) while children of educated fathers (OR 0.340, 95% CI 0.119 to 0.973), those receiving complementary food at 6 months (OR 0.368, 95% CI 0.148 to 1.393) and those practising good hygiene (OR 0.310, 95% CI 0.153 to 0.631) had lower odds (p<0.05) of being underweight. Boys (OR 3.702, 95% CI 1.537 to 8.916) had higher odds of being wasted, whereas children of educated mothers (OR 0.480, 95% CI 0.319 to 4.660), those from nuclear families (OR 0.356, 95% CI 0.113 to 1.117), those receiving early breast feeding (OR 0.435, 95% CI 0.210 to 1.341) and those practising hand washing (OR 0.290, 95% CI 0.112 to 0.750) had lower odds (p<0.05) of being wasted.
    CONCLUSIONS: This study demonstrated the sex of the child, illiteracy of fathers, not practising hand washing and not observing hygiene, late initiation of breast milk, complementary feeding timings, and lack of proper exclusive breast feeding as contributing factors to the under-nutrition of the children in the study population.
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  • 文章类型: Journal Article
    背景:营养不良对5岁以下儿童有重要的短期和长期影响。营养不良包括营养不良,营养过剩,两者共存,被称为营养不良的双重负担(DBM)。目的:本研究的目的是估计营养不良的患病率,营养过剩,在国家一级和巴拿马的居住区,这些儿童中的DBM。方法:数据来自巴拿马国家健康调查(ENSPA,西班牙语首字母缩写),以人口为基础,使用2019年进行的横断面研究。发育迟缓,浪费,超重,肥胖是根据世界卫生组织增长标准的分界点定义的。营养不良被定义为仅发育迟缓,仅浪费或两者兼有;营养过剩被定义为仅超重或仅肥胖;DBM被定义为同一孩子发育迟缓和超重/肥胖的共存。对国家一级和居住面积的患病率和一般特征进行了加权。研究结果:在全国范围内,营养不良的患病率为15.3%(95%置信区间(CI)13.4-17.3),在土著地区为36.6%(CI:30.1-43.5)。在全国范围内,营养过剩的患病率为10.2%(8.2-12.6),为11.9%(CI:8.5-16.3),8.4%(CI:6.5-10.7)和8.7%(CI:5.2-14.3)在城市,农村和土著地区,分别。全国DBM患病率为1.4%(CI:1.0-2.1),土著地区为2.7%(CI:1.4-5.1)。结论:营养不足仍然是我国最普遍的营养不良状况。巴拿马是中美洲营养过剩患病率最高的国家。在土著地区的儿童中,营养不良和DBM的患病率最高。
    Background: Malnutrition has important short- and long-term consequences in children under age five. Malnutrition encompasses undernutrition, overnutrition, and the coexistence of both of them, known as the double burden of malnutrition (DBM). Objective: The aim of this study was to estimate the prevalence of undernutrition, overnutrition, and the DBM among these children at the national level and by living area in Panama. Methods: Data from the National Health Survey of Panama (ENSPA, Spanish acronym), a population-based, cross-sectional study carried out in 2019 were used. Stunting, wasting, overweight, and obesity were defined according to the cut-off points of the World Health Organization Growth Standards. Undernutrition was defined as being stunted only, wasted only or both; overnutrition was defined as being overweight only or obese only; and the DBM was defined as the co-occurence of stunting and overweight/obesity in the same child. Prevalence and general characteristics at the national level and by living area were weighted. Findings: The prevalence of undernutrition was 15.3% (95% confidence interval (CI) 13.4-17.3) at the national level and 36.6% (CI: 30.1-43.5) in indigenous areas. The prevalence of overnutrition was 10.2% (8.2-12.6) at the national level and 11.9% (CI: 8.5-16.3), 8.4% (CI: 6.5-10.7) and 8.7% (CI: 5.2-14.3) in urban, rural and indigenous areas, respectively. The DBM prevalence was 1.4% (CI: 1.0-2.1) at the national level and 2.7% (CI: 1.4-5.1) in indigenous areas. Conclusions: Undernutrition is still the most prevalent malnutrition condition in our country. Panama has the highest prevalence of overnutrition in Central America. The highest prevalence of undernutrition and DBM was found among children living in indigenous areas.
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  • 文章类型: Journal Article
    浪费猴猴综合征(WMS),圈养的普通猴(Callithrixjacchus)菌落中的一种严重疾病,与高死亡率有关。WMS的具体病因尚不清楚,有效的治疗方法很少。以前,我们报道了一种支持措施的氨甲环酸治疗作为WMS的有用治疗方法.在本研究中,我们描述了改进的方法:每周5次皮下注射0.1毫升5%氨甲环酸,每周三次静脉注射2.0毫升氨基酸制剂,5.0mL林格氏液与0.1mL维生素制剂皮下每周三次,每周5次口服0.1mL铁制剂。我们还描述了如何通过隐静脉静脉内施用溶液,并带有约束动物的尖端,以及口服和皮下给药的详细方法。改进的方法具有与原始WMS处理方法相当的效率。
    Wasting marmoset syndrome (WMS), a serious disease in captive common marmoset (Callithrix jacchus) colonies, is associated with a high mortality rate. The specific cause of WMS is still unclear and there are few effective treatments. Previously, we had reported a tranexamic acid therapy with supportive measures as a useful treatment for WMS. In the present study, we describe the modified method: a combination of 0.1 mL of 5% tranexamic acid subcutaneously five times per week, 2.0 mL of amino acid formulation intravenously three times per week, 5.0 mL of Ringer\'s lactate with 0.1 mL of a vitamin formulation subcutaneously three times per week, and oral administration of 0.1 mL of an iron formulation five times per week. We also describe how to administer the solution intravenously via the saphenous vein with a tip of restraining the animal, as well as the detailed methods for oral and subcutaneous administration. The modified methods have comparable efficiency to the original WMS treatment method.
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  • 文章类型: Journal Article
    背景:青少年母亲和儿童营养不良是非洲面临的重大挑战,但是关于青春期母亲对孩子健康和营养的影响的数据有限。这项研究评估了婴儿喂养的做法,青春期母亲的流行,曼古地方政府区(LGA)婴儿营养不良。方法:采用多阶段抽样进行横断面调查。使用经过验证的问卷收集社会人口统计数据,并使用适当的工具进行人体测量。将数据与既定标准进行比较。描述性统计工具,ChiSquare,皮尔逊相关性,采用独立样本t检验进行数据分析,显著性设置为p<0.05。结果:共有200名母亲完成了这项研究。大多数婴儿(78.5%)不到6个月,6-12月龄占21.5%。39%的母亲报告在1小时内开始母乳喂养,而38%的人实行乳前喂养。只有28.5%的人实行纯母乳喂养,所有的母亲都用母乳喂养婴儿。青少年母亲的患病率为37.5%。发育迟缓的患病率,浪费,婴儿体重不足占29.5%,12%,和8.5%,分别。与19岁以上母亲的孩子相比,青春期母亲的孩子严重发育迟缓的发生率更高。青春期母亲的孩子与19岁以上的母亲之间的发育迟缓率和体重指数存在显着差异(p=0.017和p=0.029)。结论:青少年母亲有助于儿童慢性营养不良,ManguLGA的婴儿营养不良患病率很高,高原州。
    Background: Adolescent motherhood and malnutrition among children are significant challenges in Africa, but there is limited data on the impact of adolescent motherhood on their children\'s health and nutrition. This study assessed infant feeding practices, prevalence of adolescent motherhood, and malnutrition among infants in Mangu local government area (LGA). Methodology: A cross-sectional survey using multistage sampling was conducted. Validated questionnaires were used to collect socio-demographic data, and appropriate tools were used for anthropometric measurements. Data were compared with established standards. Descriptive statistical tools, chi square, Pearson correlation, and independent sample t-test were used for data analysis, with significance set at p < 0.05. Results: A total of 200 mothers completed the study. The majority of the infants (78.5%) were less than 6 months old, and 21.5% were 6-12 months old. Breastfeeding initiation within 1 hour was reported by 39% of mothers, while 38% practiced prelacteal feeding. Only 28.5% practiced exclusive breastfeeding, and all mothers breastfed their babies. The prevalence of adolescent motherhood was 37.5%. The prevalence of stunting, wasting, and underweight among infants were 29.5%, 12%, and 8.5%, respectively. Children of adolescent mothers had higher rates of severe stunting compared to children of mothers above 19 years of age. There were significant differences (p = 0.017 and p = 0.029) in stunting rates and weight-for-age indices between children of adolescent mothers and mothers above 19 years of age. Conclusion: Adolescent motherhood contributes to chronic malnutrition in children, and there is a high prevalence of malnutrition among infants in Mangu LGA, Plateau State.
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  • 文章类型: Journal Article
    儿童营养不良是世界上和埃塞俄比亚最严重和最少解决的健康问题之一。营养不良的患病率,体重不足,浪费了44%,29%,分别为10%。阿姆哈拉地区的营养不良率最高,为52%,33.4%,五岁以下儿童为9.9%。这项研究的目的是评估生活在BahirDar市贫民窟地区的5岁以下儿童的营养不良患病率及其相关因素。
    对BahirDarTown贫民窟地区的680名6-59个月的儿童进行了一项基于社区的横断面研究。使用大规模抽样技术选择研究参与者,并使用预先测试的结构化问卷和人体测量数据从2018年4月至6月收集数据。最后,收集的数据被编码,输入,清洁,记录,并存储,并使用EPIINFO对数据进行处理并导出到SPSS25.0版统计软件包中。使用双变量和多变量分析进行Logistic回归分析和解释。
    共有680名儿童参加。发育迟缓的患病率,体重不足,消瘦率为46.2%(95%CI;42.5-49.1),24.3%(95%CI;21.2-27.6),和11.3%(95%CI;CI;9.2-13.9)。收入组包括儿童[AOR=3.476(95%CI,1.959-6.167)],男性儿童[AOR=2.586(95%CI;1.532-4.365)]和母亲的教育水平[(AOR=2.600)(1.623)-4.164)]与营养不良显著相关。
    这项研究的结果表明,由于发育迟缓和消瘦而导致的营养不良的患病率在五岁以下的儿童中很高。孩子的性别,母亲的教育水平,发现家庭的月收入与营养不良显着相关。推广使用计划生育,预防腹泻病,通过营养教育计划为儿童接种疫苗是改善儿童营养状况的重要活动。
    UNASSIGNED: child malnutrition is one of the most serious and least addressed health problems in the world and in Ethiopia. The prevalence of malnutrition, underweight, and wasting was 44%, 29%, and 10% respectively. The Amhara region has the highest rates of malnutrition at 52%, 33.4%, and 9.9% for children under five. The aim of this study was to assess the prevalence of malnutrition and its associated factors among children under five living in the slum areas of Bahir Dar City.
    UNASSIGNED: a community-based cross-sectional study was conducted with 680 children aged 6-59 months in slum areas of Bahir Dar Town. Study participants were selected using a mass sampling technique and data were collected from April to June 2018 using a pre-tested structured questionnaire and anthropometric measurements. Finally, the collected data were coded, entered, cleaned, recorded, and stored, and the data were processed using EPI INFO and exported to the SPSS version 25.0 statistical package. Logistic regression analysis and interpretation were performed using bivariate and multivariate analysis.
    UNASSIGNED: a total of 680 children participated. The prevalence of stunting, underweight, and wasting was 46.2% (95% CI; 42.5-49.1), 24.3% (95% CI; 21.2-27.6), and 11.3% (95% CI; CI; 9.2-13.9). Income groups included children [AOR=3.476 (95% CI, 1.959-6.167)], male children [AOR=2.586 (95% CI; 1.532-4.365)] and mother\'s educational level [(AOR=2.600) (1.623) - 4.164)] were significantly associated with malnutrition.
    UNASSIGNED: the results of this study showed that the prevalence of malnutrition due to stunting and wasting was high among children under five years of age. The gender of the child, the educational level of the mother, and the monthly income of the family were found to be significantly related to malnutrition. Promoting the use of family planning, preventing diarrheal diseases, and vaccinating children through nutrition education programs are important activities to improve the nutritional status of children.
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  • 文章类型: Journal Article
    尽管全球贫困和饥荒显著减少,严重的儿童营养不良继续存在。2017年,超过5000万和1.5亿幼儿患有急性营养不良(消瘦)和慢性营养不良(发育迟缓)。分别。然而,决定因素的可衡量影响是模糊的。我们评估了肯尼亚和尼日利亚的发育迟缓和消瘦的社会环境相关决定因素,并量化了它们的有效性。我们将肯尼亚和尼日利亚人口健康调查(2003年,2008年-2009年,2013年,2014年)的健康和人口统计数据与空间明确的降水相结合,温度,和植被数据。地理空间和分类数据有助于更好地了解谁处于危险之中,以及在哪里开展缓解工作。我们使用四级随机截距分层广义Logit模型评估营养不良指标的反应性。我们发现空间和等级关系解释了28%至36%的营养不良结果变化。降水的时间变化,温度,植被的营养不良率变化超过50%。浪费受母亲教育的影响最大,家庭财富,临床分娩,和疫苗接种。发育迟缓受家庭财富的影响最大,母亲的教育,临床分娩,疫苗接种,和没有发烧症状的儿童,咳嗽,或腹泻。远程监测的气候变量是强大的决定因素,然而,它们的影响在不同的指标和地点是不一致的。
    Despite a remarkable reduction in global poverty and famines, substantial childhood malnutrition continues to persist. In 2017, over 50 million and 150 million young children suffered from acute malnutrition (wasting) and chronic malnutrition (stunting), respectively. Yet, the measurable impact of determinants is obscure. We evaluate proposed socio-environmental related determinants of stunting and wasting across Kenya and Nigeria and quantify their effectiveness. We combine health and demographic data from Kenya and Nigeria Demographic Health Surveys (2003, 2008-2009, 2013, 2014) with spatially explicit precipitation, temperature, and vegetation data. Geospatial and disaggregated data help to understand better who is at risk and where to target mitigation efforts. We evaluate the responsiveness of malnutrition indicators using a four-level random intercept hierarchical generalized logit model. We find that spatial and hierarchical relationships explain 28% to 36% of malnutrition outcome variation. Temporal variation in precipitation, temperature, and vegetation corresponds with more than a 50% change in malnutrition rates. Wasting is most impacted by mother\'s education, family wealth, clinical delivery, and vaccinations. Stunting is most impacted by family wealth, mother\'s education, clinical delivery, vaccinations, and children asymptomatic of fever, cough, or diarrhea. Remotely monitored climatic variables are powerful determinants, however, their effects are inconsistent across different indicators and locations.
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  • 文章类型: Journal Article
    Cancer cachexia, often referred to as \"wasting syndrome,\" is characterized by fatigue, weakness, and involuntary weight loss. This syndrome is concomitant with progressive skeletal muscle atrophy with or without adipose tissue loss and is frequently accompanied by systemic inflammation. Understanding the complexities of cancer cachexia is crucial for early detection and intervention, and it is also paramount for enhancing patient outcomes. Medical imaging, comprising diverse imaging modalities, plays a pivotal role in this context, facilitating the diagnosis and surveillance assessment of both the disease extent and the body composition changes that offer valuable information and insights into disease progression. This article provides a comprehensive discourse of the pathophysiological mechanisms and clinical manifestations of cancer cachexia as well as the role of medical imaging in this setting. Particular emphasis is placed on contemporary multidisciplinary and translational research efforts for the development of diagnostic and treatment tools, aiming to mitigate the devastating consequences of cancer cachexia.
    UNASSIGNED: Tumorkachexie wird häufig als „Auszehrungssyndrom“ bezeichnet und ist charakterisiert durch Fatigue, Schwäche und ungewollte Gewichtsabnahme. Dieses Syndrom tritt begleitend bei progressiver Skelettmuskelatrophie mit oder ohne Fettgewebsverlust auf und geht oft mit systemischer Entzündungsreaktion einher. Das Verständnis der Komplexität der Tumorkachexie ist entscheidend für die rechtzeitige Erkennung und Behandlung und von zentraler Bedeutung für die Verbesserung der Patientenergebnisse. In diesem Zusammenhang spielt die medizinische Bildgebung mittels diverser Bildgebungsmodalitäten eine ausschlaggebende Rolle. Sie erleichtert die Diagnosestellung und die Kontrolluntersuchungen sowohl des Krankheitsausmaßes als auch der Veränderung der Körperzusammensetzung, die wertvolle Informationen und Einsichten in den Krankheitsprogress ermöglichen. In der vorliegenden Arbeit wird eine umfassende Erörterung der pathophysiologischen Mechanismen und klinischen Manifestationen der Tumorkachexie sowie der Bedeutung der medizinischen Bildgebung in diesem Rahmen gegeben. Besonderer Wert wird auf die aktuellen multidisziplinären und translationalen wissenschaftlichen Bestrebungen für die Entwicklung diagnostischer und therapeutischer Instrumente gelegt, die darauf abzielen, die verheerenden Folgen der Tumorkachexie abzumildern.
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  • 文章类型: Journal Article
    背景:在中低收入国家,大多数营养评估使用最新的重量,不参考增长轨迹。
    目的:本研究探讨了速度,除了最新的重量,提高了浪费的预测,在生命的头两年发育迟缓或死亡。
    方法:我们分析了一个综合数据集,其中包括在第一年每月收集的3447名巴基斯坦儿童的体重和身高数据,马拉维,南非,记录身高和生存率,直至24个月。主要暴露是每个2个月结束时的体重年龄z得分(WAZ)和该时期的体重速度年龄z得分(WVZ2)。结果浪费了,在接下来的1-2个月内发育迟缓或全因死亡。作为敏感性分析,我们还使用了超过6个月的WVZ(WVZ6),与WAZ相匹配。使用具有重复生长测量的Cox比例风险模型来研究暴露与死亡率之间的关联。混合泊松模型用于发育迟缓和消瘦。
    结果:已经发育迟缓或浪费的儿童最有可能保持这种状态。WVZ2与随后发育迟缓的风险较低相关(RR0.95;95%CI0.93-0.96),但与仅包括WAZ的模型相比,增加了最小的预测(AUC差异=0.004)。同样,WVZ2与消瘦相关(RR0.74;95%CI0.72-0.76),但预测仅略高于WAZ(AUC差异=0.015)。与WAZ相比,WVZ6对消瘦和发育迟缓的预测能力较低。低WVZ6(但非WVZ2)与死亡率增加相关(HR0.75,95%CI0.67-0.85),但只在仅包括WAZ的模型中添加了边际预测(C=0.015的差异)。
    结论:即将消瘦的关键人体测量决定因素,发育迟缓,和死亡率似乎是孩子的体重低于正常范围,而不是他们是如何到达那个位置的。
    BACKGROUND: In low/middle-income countries, most nutritional assessments use the latest weights, without reference to growth trajectory.
    OBJECTIVE: This study explores whether velocity, in addition to the latest weight, improves the prediction of wasting, stunting, or mortality in the first 2 years of life.
    METHODS: We analyzed a combined data set with weight and height data collected monthly in the first year of 3447 children from Pakistan, Malawi, and South Africa, with height and survival recorded till 24 m. The main exposures were weight-for-age z-score (WAZ) at the end of each 2-m period and weight velocity-for-age z-score (WVZ2) across that period. The outcomes were wasting, stunting, or all-cause mortality in the next 1-2 mo. As a sensitivity analysis, we also used WVZ over 6 mo (WVZ6), with matching WAZ. Cox proportional hazard models with repeated growth measures were used to study the association between exposures and mortality. Mixed Poisson models were used for stunting and wasting.
    RESULTS: Children who were already stunted or wasted were most likely to remain so. Higher WVZ2 was associated with a lower risk of subsequent stunting (risk ratio [RR]: 0.95; 95% confidence interval [CI]: 0.93, 0.96), but added minimal prediction (difference in AUC = 0.004) compared with a model including only WAZ. Similarly, lower WVZ2 was associated with wasting (RR: 0.74; 95% CI 0.72, 0.76) but the prediction was only marginally greater than for WAZ (difference in AUC = 0.015). Compared with WAZ, WVZ6 was less predictive for both wasting and stunting. Low WVZ6 (but not WVZ2) was associated with increased mortality (hazard ratios: 0.75, 95% CI: 0.67, 0.85), but added only marginal prediction to a model including WAZ alone (difference in C = 0.015).
    CONCLUSIONS: The key anthropometric determinant of impending wasting, stunting, and mortality appears to be how far below the normal range the child\'s weight is, rather than how they reached that position.
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