Malnourished Subjects Research Articles

Delirium in malnourished elderly subjects: Could it be refeeding syndrome?

Refeeding syndrome (RS) is a potentially serious but underrecognized phenomenon in geriatric medicine. It can occur in malnourished elderly subjects when feeding is re-introduced after a period of fasting. The clinical presentation of RS is unspecific, and it is often accompanied by psychomotor impairment suggestive of delirium. In this article, illustrated by 2 clinical cases, we report a series of 13 patients with RS, of whom 11 had delirium. Treatment of RS is based on progressive refeeding and phosphate, magnesium, potassium and thiamine supplementation. This combination leads to favorable outcome and disappearance of delirium in a majority of patients.

Weight-for-height and mid-upper-arm circumference should be used independently to diagnose acute malnutrition: policy implications

Anthropometric surveys of children are used to assess the nutritional status of a population. World Health Organization (WHO) recommends that either mid-upper-arm circumference (MUAC) or weight-for-height Z-scores (WHZ) are used to assess acute malnutrition prevalence. However, there are reports from several countries that the two criteria identify different children. In order to examine the external validity of these observations we have compared the direction and degree of discrepancy across countries. Anonymous data were collected from 1832 anthropometric surveys from 47 countries with measured children aged from 6 to 59 months and at least 75 malnourished subjects. The prevalence of total acute malnutrition and severe acute malnutrition was calculated using either absolute-MUAC or WHZ (WHO2006 standards). For each country, the total number of children diagnosed as acutely malnourished by either criterion alone or by both criteria were summed from all the surveys conducted in that country. In all countries a minority of children were diagnosed as malnourished by both criteria. Both the magnitude and direction of the discrepancy varied dramatically between countries with some having most children diagnosed as malnourished by MUAC and others where nearly all the children were diagnosed by WHZ alone. Eight additional countries with insufficient malnourished children were also analysed and they support the conclusions. For all countries examined the discrepancy was not adequately explained by any single hypothesis, such as variation in relative leg to body length. The perceived need for humanitarian intervention can be affected by the measurement chosen to assess the prevalence of malnutrition which will vary from region to region. It is recommended that MUAC measurement be included in all anthropometric surveys and that the two criteria are not alternative measures of the loss of body tissue leading to an increased risk of death, but complementary variables that should both be used independently to guide admission for treatment of malnourished children.

An Epidemiological Study of Malnutrition in Children of Chandigarh And Surrounding Areas.

Malnutrition is a silent emergency. Child Malnutrition is a deficiency diseases due to insufficient intake of one or more specific nutrients such as vitamins or minerals. In the assessment of child malnutrition, a large number of measures are available. 2048 children had undergone questionnaire and dietary survey and health examination. In the present study, according to BMI categories, malnutrition is more pronounced in girls as compared to boys. Malnourished females were 69.79% as compared to males (64.69%) and malnourished subjects were more in rural population (71.29%) than the urban population (61.16%). In the present study, according to BMI-for-age percentile, 24.80% children were underweight in of 10–19 age groups. Underweight children were more in rural population (28.81%) as compared to urban population (20.75%). In the present study children and adolescents of age groups 10–19, 66.26% are malnourished and underweight and most of the females (69.79%) are malnourished and underweight. We are raising a generation which is debilitated and cannot contribute effectively to our country economically and other wise.

Recommendations Concerning the First-Line Treatment of Children with Tuberculosis.

This document describes the recommendations of a group of scientific societies concerning the first-line therapeutic approach to paediatric tuberculosis (TB). The treatment of pulmonary TB should be based on the existence of parenchymal involvement and the risk of antibiotic resistance. The treatment of extra-pulmonary TB is based on the regimens used for severe pulmonary TB. The administration of corticosteroids is recommended only in cases of miliary TB, tuberculous meningitis and tuberculous pericarditis. Vitamin B6 may be indicated in the case of isoniazid-treated TB in breastfeeding infants, severely malnourished subjects, or patients with other diseases at high risk of vitamin deficiency. Once having started treatment, children with TB should be carefully followed up in order to evaluate compliance, the response to treatment, the need for treatment changes, and the presence of drug-related adverse events. Primary care paediatricians can support reference centres in providing family healthcare education and encouraging treatment compliance.

Assessing the nutritional status of older individuals in family practice: Evaluation and implications for management

Malnutrition is emerging as a multidimensional concern of ageing with a high prevalence among nursing home residents. This study investigated the extent of malnutrition among old subjects in family practice and its relationship with major complications. Over 75 years old subjects (n = 274) filled the Mini Nutritional Assessment questionnaire. Appearance of major events in the following 6 months were registered. MNA scored were 11.5 ± 3.1, with 175 (64%) subjects showing no malnutrition, 69 (25%) resulted at risk, and 30 (11%) malnourished. Within at risk group, 1.4% was resident, 7% bed rested, 8% had a history of major bone fracture, 33% was demented and 24.6% hospitalized at least once in the last year. Among malnourished patients, 10% was resident, ten bed rested with 70% showing multiple bedsores, 20% have had bone fractures, 60% were demented and 13% hospital admitted in the previous year. In over 90% of them, malnutrition had neither diagnosed nor considered before. During follow-up, a significantly higher number of major events including death occurred in the malnourished group. By multivariate logistic regression, n = 56 (20.4%) patients resulted at risk of major complications. The sensitivity of the questionnaire in identifying these patients was 84% with the cut-off value of 7 associated with the highest prediction (positive predictive value, 0.92; negative predictive value, 0.71) yielding a specificity of 92%. The prevalence of malnutrition is high among older subjects in the setting of family practice. The Mini Nutritional Assessment allows to identify malnourished subjects better than BMI and effectively predicts the risk of major events.

Application of Connectionist Approach in Classification of Nutritional Status Among Arsenic Affected people in Rural Areas in Bangladesh

Various methods can be applied to build predictive models for the clinical data with binary outcome variables. This research aims to explore and compare the process of constructing common predictive models. Models based on an artificial neural network (the connectionist approach) and binary logistic regressions were compared in their ability to classifying malnourished subjects and those with over-weighted participants in rural areas of Bangladesh. Subjects were classified according to the indicator of nutritional status measured by body mass index (BMI). This study also investigated the effects of different factors on the BMI level of a sample population of 460 adults of six villages in Bangladesh. Demographic, enthropometric and clinical data were collected based on a total of 460 participants aged over 30 years from six villages in Bangladesh that were identified as mainly dependent on wells contaminated with arsenic. Out of 460(140 male and 320 females) participants 186(40.44%) were identified as malnourished (BMI<18.5 gm), and the remainder 274(59.56%) were found as over-weighted (BMI>18.5 gm). Among other factors, arsenic exposures were found as significant risk factors for low body mass index (BMI) with a higher value of odds ratio. This study shows that, binary logistic regression correctly classified 72.85% of cases with malnourished in the training datasets, 76.08% in the testing datasets and 75.26% of all subjects. The sensitivities of the neural network architecture for the training and testing datasets and for all subjects were 84.28%, 84.78% and 81.72% respectively, indicate better performance than binary logistic regression model. DOI: http://dx.doi.org/10.3329/akmmcj.v5i2.21128 Anwer Khan Modern Medical College Journal Vol. 5, No. 2: July 2014, Pages 23-29

Serum albumin level in Sudanese children with edematous and non-edematous malnutrition

Introduction Edema formation in malnourished children is multifactorial and not necessarily caused by hypoalbuminemia. In Sudan, studies that evaluate serum albumin level in malnourished children are scarce, if any. The aim of this study is to assess serum albumin concentrations in Sudanese children with edematous and non-edematous malnutrition. Material and Methods The study involved 23 males matched for age and weight with 17 females. The ages of studied subjects ranged between 6 – 36 months. Weight and serum albumin levels were measured according to the standards. Patients were classified according to the presence of edema, Wellcome and Gomez classifications. In addition, patients were classified according to their levels of albumin into normal (3.5 - 4.8 g/dl), mild (2.8 - 3.4 g/dl), moderate (2.1 - 2.7 g/dl) and severe (< 2.1 g/dl) hypoalbuminemia. Results Serum albumin levels were significantly lower in malnourished subjects with edema (M±SD = 2.4±0.8 g/dl) compared to those with malnutrition but no edema ((M±SD = 3.1±0.8 g/dl, P = 0.026) However, classifying studied malnourished children according to their albumin levels revealed no significant differences in the mean of albumin when albumin levels of edematous patients were compared with non-edematous subjects in each class (P> 0.05). There was no significant correlation between weight and serum albumin level (correlation coefficient (CC) = 0.156, P = 0.337). Conclusion The current study demonstrates the tendency of edematous malnourished children to have hypoalbuminemia; nevertheless, some children with significantly low albumin are still not suffering from edema. These paradoxical results display the possible variations in the pathophysiological response to food deprivation.

Refeeding and metabolic syndromes: two sides of the same coin.

Refeeding syndrome describes the metabolic and clinical changes attributed to aggressive rehabilitation of malnourished subjects. The metabolic changes of refeeding are related to hypophosphatemia, hypokalemia, hypomagnesemia, sodium retention and hyperglycemia, and these are believed to be mainly the result of increased insulin secretion following high carbohydrate intake. In the past few decades, increased consumption of processed food (refined cereals, oils, sugar and sweeteners, and so on) lowered the intake of several macrominerals (mainly phosphorus, potassium and magnesium). This seems to have compromised the postprandial status of these macrominerals, in a manner that mimics low grade refeeding syndrome status. At the pathophysiological level, this condition favored the development of the different components of the metabolic syndrome. Thus, it is reasonable to postulate that metabolic syndrome is the result of long term exposure to a mild refeeding syndrome.

Association between nutritional status (MNA®-SF) and frailty (SHARE-FI) in acute hospitalised elderly patients.

This study aimed to explore the association between the impaired nutritional status and frailty in acute hospitalised elderly patients by using two tools, the MNA®-SF (Mini Nutritional Assessment® short-form) and the SHARE-FI (Frailty Instrument for Primary Care of the Survey of Health, Ageing and Retirement in Europe). Cross-sectional study. Acute hospitalised, community-dwelling elderly patients were recruited at internal medicine wards in Vienna, Austria. 133 men (39%) and women (61%) aged 74 (65-97) years. MNA®-SF was used to investigate malnutrition (<7 points) and patients at risk of malnutrition (8 to 11 points). By using the SHARE-FI, subjects were classified as frail, pre-frail or robust. A factor analysis was applied to identify overlaps between the MNA®-SF and SHARE-FI items. Internal consistency of different dimensions was assessed by using Cronbach's Alpha. Malnutrition or risk of malnutrition was found in 76.7% of the total sample and in 46.8% of robust, in 69.0% of pre-frail, and in 93.0% of frail participants. Frailty or prefrailty was found in 75.9% of the total sample and in 45.1% of the subjects with no risk of malnutrition, in 80.9% of subjects at risk of malnutrition, and in 94.1% of malnourished patients. The two used tools show overlaps in three dimensions: (1) nutrition problems, (2) mobility problems and (3) anthropometric items with a moderate to strong internal consistency (Cronbach's Alpha of 0.670, 0.834 and 0.946, respectively). 64.7% of the total sample (79.5% of frail and 87.9% of malnourished subjects) would participate in a home-based muscle training and nutritional intervention program. This study underlines the association and the overlap between frailty and impaired nutritional status. There is a high readiness to participate in a program to tackle the problems associated with malnutrition and frailty, especially in those, who would benefit most from it.

Malnutrition prevalence in hospitalized elderly diabetic patients.

Malnutrition prevalence is unknown among elderly patients with diabetes mellitus. Our objectives were to determine malnutrition prevalence in elderly in patients with diabetes, and to describe their impact on prognosis. An observational multicenter study was conducted in 35 Spanish hospitals. Malnutrition was assessed with the Mini Nutritional Assessment (MNA) tool. Patients were followed until discharge. 1,090 subjects were included (78 ± 7.1 years; 50% males). 39.1% had risk of malnutrition, and 21.2% malnutrition. A 15.5% of the malnourished subjects and 31.9 % of those at risk had a BMI ≥ 30 kg/m(2). In multivariate analysis, female gender (OR = 1.38; 95% CI: 1.19-1.11), age (OR = 1.04; 95% CI: 1.02-1.06) and presence of diabetic complications (OR = 1.97; 95% CI: 1.52-2.56) were associated with malnutrition. Length of stay (LOS) was longer in at-risk and malnourished patients than in well-nourished (12.7 ± 9.9 and 15.7 ± 12.8 days vs 10.7 ± 9.9 days; p < 0.0001). After adjustment by age and gender, MNA score (OR = 0.895; 95% CI 0.814-0.985) and albumin (OR = 0.441; 95% CI 0.212-0.915) were associated with mortality. MNA score was associated with the probability of home discharge (OR = 1.150; 95% CI 1.084-1.219). A high prevalence of malnutrition among elderly in patients with diabetes was observed, regardless of BMI. Malnutrition, albumin, and MNA score were related to LOS, mortality and home discharge.

What are the antioxidant status predictors' factors among male chronic obstructive pulmonary disease (COPD) patients?

Imbalance between antioxidant and oxidative stress is a major risk factor for pathogenesis of some chronic diseases such as chronic obstructive pulmonary disease (COPD). This study aimed to determine antioxidant and oxidative stress status, and also theirs association with respiratory function of male COPD patients to find the antioxidant predictors’ factors. A total of 149 subjects were involved in a cross-sectional study. The study was conducted at two medical centers in Kuala Lumpur, Malaysia. Results of the study showed that plasma vitamin C was low in most of the subjects (86.6%). Total antioxidant capacity was the lowest in COPD stage IV compare to other stages (p < 0.05). Level of plasma vitamin A (p= 0.012) and vitamin C (p= 0.007) were low in malnourished subjects. The predictors for total antioxidant capacity were forced vital capacity (FVC) % predicted and intake of β-carotene (R2= 0.104, p= 0.002). Number of cigarette (pack/year) and smoking index (number/year) were not associated with total antioxidant capacity of this COPD population. Plasma oxidative stress as assessed plasma lipid peroxidation (LPO) was only positively correlated with plasma glutathione (p= 0.002). It might be a need to evaluate antioxidant status especially in older COPD patients to treat antioxidant deficiency which is leading to prevent COPD progression.

Increased intestinal permeability in malnourished patients with liver cirrhosis

Malnutrition is a prominent feature in liver cirrhosis, with deleterious impact on clinical outcome. The objective of this study is to investigate whether malnutrition is associated with increased gastrointestinal permeability in liver cirrhosis reflected by altered urinary excretion of non-metabolizable sugar probes. Patients with advanced liver cirrhosis (Child Pugh Score B or C) were recruited. Nutritional status was determined according to the Subjective Global Assessment. Intestinal permeability was assessed by measuring the urinary excretion of orally administered, non-metabolized sugar probe molecules. The lactulose/mannitol ratio served as marker for intestinal permeability and reflects non-carrier-mediated transcellular and paracellular transport of the small intestine during the first 5 h. Sucrose recovery in urine within the first 5 h reflects gastroduodenal permeability; sucralose recovery in urine 5-26 h after consumption reflects colonic permeability. Sixty-four patients (56.7±10.8 years; 33% female) were included in the study. Twenty-one patients were considered well nourished according to the Subjective Global Assessment, 23 moderately nourished and 20 patients severely malnourished; 74% had alcoholic liver disease and 67% had cirrhosis stage Child C. Gastroduodenal and colonic permeability was significantly increased in patients with liver cirrhosis compared with 63 healthy controls (0.23±0.22 and 1.37±1.42% vs 0.14±0.10 and 0.41±0.72% in controls), but not different between well and malnourished subjects. Small intestinal permeability (lactulose/mannitol ratio) was increased in all patients (0.069±0.055%) and further increased in malnourished patients (0.048±0.031% vs 0.084±0.061%, P=0.004) due to decreased mannitol recovery only. Gastric, small intestinal and even colonic permeability was altogether increased in liver cirrhosis, and malnutrition was associated with further increased small intestinal permeability indicative of villous atrophy.

Usefulness of Subjective Global Assessment Tool in Assessing the Nutritional Status of Critically Ill Pediatrics

Objectives: To determine the incidence of malnutrition in pediatric patients admitted in a critical care unit and to evaluate the value of SGA as a nutrition assessment tool in this patient group. Patients and Method: The study included 260 pediatric patients aged one month to 6 years who were admitted to the pediatric intensive care unit at Sri Ramachandra Hospital from January, 2010 to April, 2011. Weight of each patient was checked using a weighing pan/scale and evaluated using IAP Weight for Age criteria (W/A). Nutrition related history according to SGA protocol was taken from the care takers of each patient by a trained nutritionist. Data from the SGA history was summarized into one of three class groups; A-well nourished, B-moderately malnourished and C-severely malnourished. Results: Overall, around 50.4% of our study subjects were well nourished, 34.5% were moderately malnourished and 16.1% were severely malnourished. SGA was able to identify malnourished subjects with 86.71% sensitivity and specificity of 86.36% when compared with IAP weight for age criteria. Conclusions: SGA is a sensitive and specific nutrition assessment tool useful in pediatric patients admitted in a critical care unit. Application of the protocol as a complement of standard anthropometric tool can be considered. Keywords : Malnutrition, Subjective Global Assessment, Critically ill Paediatrics, Nutritional assessment.

Bioelectrical Impedance Vector Analysis and Mini Nutritional Assessment in elderly nursing home residents.

The aim of this study was to establish the presence of malnutrition in elderly institutionalized people through Mini Nutritional Assessment (MNA) scores and to observe the changes of nutritional status through the Bioelectrical Impedance Vector Analysis (BIVA). Observational study. Nursing home located in the territory of Florence (Italy). 463 elderly individuals from twelve nursing homes, all aged 65 yrs or over. We carried out the MNA and measured the bioelectrical parameters of resistance (R) and reactance (Xc), with standard, tetrapolar analysis at 50 kHz frequency; these bioelectrical parameters were interpreted according to BIVA analysis. According to the MNA score, 23.1% of the women and 20.4% of the males are malnourished (MNA < 17), 60.0% and 52.8%, respectively, are at risk for malnutrition (17 ≤ MNA ≤ 23.5). Malnourished, at-risk and well-fed subjects differ significantly (p < 0.05) in their mean scores obtained in each of the MNA areas. Fifteen of eighteen MNA items show a significant correlation to the total MNA score (p < 0.001). The items not significantly related to the MNA global score were those concerning protein intake, independence and number of medicinal drugs taken. In both genders, the decrease of the MNA score increases the proportion of subjects placed outside the 95% confidence ellipse on the BIVA tolerance graph. A routine assessment of nutritional status through BIVA analysis combined with more "traditional" tools like the MNA could be useful for recognizing malnutrition and the risk of malnutrition in the elderly as these instruments provide complete information and are easy to use even with heavily impaired subjects.

Survival and prognostic factors of childhood acute lymphoblastic leukemia

Background The treatment protocols of childhood acutelymphoblastic leukemia (ALL) have been improved.Some factors such as age, sex, and nutritional status couldinfluence therapy outcome.Objective To study the survival differences among age, sex,and nutritional status groups in childhood ALL.Methods A retrospective Kaplan-Meier survival analysis ofchildhood ALL was performed in Cipto MangunkusumoHospital since January 1st 1998 until December 31st 2003.We excluded patients aged &lt; 1 years, those with L3 subtype,patients with modified chemotherapy protocol, or withincomplete data.Results A total of 252 patients were analyzed. Overallsurvival of 1-2 year old, &gt; 2-&lt; 10 year old, and 10-18 yearold subjects were 57% (95% CI 38 to 76%), 47% (95% CI40 to 54%), and 35% (95% CI 21 to 49%) respectively (P&lt; 0.05). Five-year -event-free survival (EFS) of 1-2 year old,&gt; 2-&lt; 10 year old, and 10-18 year old subjects were 40%,40%, and 16%, respectively (P &lt;0.05). Overall survival ofmale and female subjects were 46% and 53% respectively(P &gt;0.05). Five-year-EFS of male and female subjects were29% and 45% (P &gt;0.05). Overall survival of well-nourished,undernourished, and malnourished patients were 42%50%and 57% respectively (P &gt;0.05). The five-year-EFS of wellnourished, undernourished, and malnourished subjects were33%,38%, and 51%, respectively (P &gt;0.05).Conclusion Childhood ALL aged 1-2 years had the highestsurvival rate while those of 10-18 year old had the lowest. Therewere no survival rate differences between sex and nutritionalstatus groups.

Investigation of the potential of fortified instant matooke flour (ITF) in rehabilitation of malnourished children. Part II: Testing potential of ITF as a vehicle food for malnutrition intervention.

This study was done to establish potential of instant Tooke (cooking banana) flour (ITF) as a vehicle food for malnutrition intervention. Hypotheses generated were: (1) There is a significant difference in response with respect to weight gain between malnourished subjects rehabilitated using fortified IFT and Mwanamugimu Diatery Regime (MDR); (2) There is a significant difference in response with respect to serum albumin, ferritin and retinol levels between fortified ITF and MDR. To test the hypotheses, 100 malnourished children admitted at Mwanamugimu Nutrition Unit in Uganda, were randomly allocated to a test (IFT diet from part I of study) or control (MDR diet) group. Growth rates and food intake were measured daily, while blood samples were withdrawn during recruitment and before discharge for testing serum albumin, ferritin and retinol levels. Means were compared using SPSS version 11. The test and control diets were adequate in protein but relatively lower for energy against RDA. Protein and energy intake in the test group was significantly (P < 0.05) higher for porridge, while protein intake in the control group was significantly (P < 0.05) higher for kitoobero. Weight gain in the test was significantly (P < 0.05) higher than the control group. However, both groups showed no significant difference in the bio-chemical indicators. The superiority of fortified ITF formulation over the MDR was proved with respect to weight gain but not for the biochemical indicators. Hypothesis one was accepted but two was rejected. Key words: Instant tooke flour (ITF), matooke, malnourished, rehabilitation.

Iodine: It's Important in Patients that Require Parenteral Nutrition

Iodine deficiency has multiple adverse effects on growth and development because of inadequate thyroid hormone production. Four methods are generally recommended for assessment of iodine nutrition: urinary iodine concentration, thyroid size, and blood concentrations of thyroid-stimulating hormone and thyroglobulin. Iodine intakes < or = 1 mg/d are well tolerated by most adults, because the thyroid is able to adjust to a wide range of intakes. A daily dose of 1 microg iodine/kg body weight is recommended for infants and children receiving parenteral nutrition (PN), but this is far below their requirement. Daily iodine requirements in adults receiving enteral nutrition or PN are estimated to be 70-150 microg, but most PN formulations do not contain iodine. Despite this, deficiency is unlikely because absorption from iodine-containing skin disinfectants and other adventitious sources can provide sufficient iodine. However, if chlorhexidine replaces iodine-containing disinfectants for catheter care, iodine deficiency may occur during long-term PN, and periodic testing of thyroid functions may be prudent. Infants may be particularly vulnerable because of their small thyroidal iodine store, but available data do not yet support routine supplementation of preterm infants with iodine. Adults may be less vulnerable because thyroidal iodine stores may be able to support thyroid hormone production for several months. More studies to clarify this issue would be valuable.

Basics in Clinical Nutrition: Refeeding syndrome

Refeeding syndrome is known as a dangerous consequence of rapid and excessive food intake in severely malnourished subjects. This condition occurred in wartime when prisoners of war were quickly re-nourished after their liberation and they died suddenly. Formerly, various gastrointestinal problems were supposed to be responsible for these problems, but autopsy did not demonstrate any substantial GI changes. However, even at the present time the refeeding syndrome is a not unusual complication of artificial nutrition, with an incidence of 5 to 25% (cancer patients). It occurs commonly with parenteral or enteral realimentation of previously malnourished patients who have lost more than 10% of their body weight over the previous two months. The following groups of patients are especially prone to develop refeeding syndrome:

Thyroid function in altered nutritional state.

We studied plasma concentrations of TSH (basal and after TRH), thyroxine (T4), 3,5,3'-triiodothyronine (T3), 3,3',5'-triiodothyronine (reverse T3; rT3), free T4 and free T3 in thirty obese subjects, twenty patients with anorexia nervosa, fifteen malnourished subjects and twenty normal weight subjects. Total serum T4 values were similar for the four groups of subjects while serum free T4 values were slightly increased in anorexia nervosa and normal in the other groups. Serum total and free T3 levels were both significantly decreased in anorexia nervosa and malnutrition, and within normal limits in obesity. The mean serum rT3 level was increased in anorexia nervosa and malnutrition while was reduced in obesity. A delay in peak response of TSH to TRH stimulation (30' rather than 20') was noted in anorexia and malnourished patients. The results suggest that these alterations of serum iodothyronines are due to a different peripheral conversion of T4 to T3 according to nutritional status.

How safe is the use of prosthetic materials in the repair of abdominal-wall defects in malnourished subjects?

AbstractIncisional hernias and abdominal-wall defects consume large amounts of healthcare resources. Use of mesh is effective in treatment of these disorders and can decrease the rate of recurrence. This experimental study focused on the safety of mesh use in the setting of malnutrition, a condition that impairs wound healing. Rats were divided into two groups: normally fed and food-restricted. An abdominal-wall defect, 2 by 2 cm, was covered with polypropylene mesh, 2.5 by 2.5 cm. After sacrifice of the rats at the 21st and 60th days, tissue samples were sent for tensiometric and histopathological studies. No significant difference in infectious complications was observed between the two groups. Tensiometry revealed no significant differences between the groups. On histopathological examination, the only difference noted was in the vascularization scores of normally fed rats. For malnourished subjects that survived after surgery, the use of polypropylene mesh appeared safe in the closure of abdominal-wall defects, with no increase in infection rate and satisfactory wound healing.