Poor Appetite Research Articles

Determinants of nutritional status among old age population in eastern Ethiopia: a general linear model approach.

As the world's aging population grows, nutrition and health issues are becoming a major concern. The aim of the present study was to identify the factors associated with nutritional status among old age population. A community-based cross-sectional study was employed among randomly selected 739 elders over the age of 60 in Dire Dawa City administration, eastern Ethiopia. The validated full mini nutritional assessment tool and appetite test (SNAQ) was used to assess the nutritional status of the study population. Considering the ranked nature of the data, a bivariate and multivariable ordinal logistic regression model (under the generalised linear model) was conducted, with crude and adjusted odds ratios reported along with 95 % confidence intervals. Statistically significant associations are declared at P-value less than 0⋅05. In this study, 22 % (95 % CI: 19 %, 25 %) of elders were malnourished. Participants with >75 years old (AOR 4⋅95; 95 % CI 1⋅54, 8⋅4), being female (AOR 1⋅6; 95 % CI 1⋅1, 2⋅2), illiterate (AOR 1⋅5; 95 % CI 1⋅01, 2⋅2), severe depression (AOR 13⋅9; 95 % CI 8⋅2, 23⋅7) and with poor appetite (AOR 3⋅3; 95 % CI 2⋅3, 4⋅8) were important predictors of malnutrition among older age group. We found that the prevalence of malnutrition and the risk of malnutrition is a public health concern that warrants intervention in the area. Advanced age, illiteracy, depression and poor appetite were important risk factors for malnutrition among older age group. The identified risk factors will guide public health professionals and programmes in the design, implementation of interventions to improve the nutritional status of older age group.

EARLY ENTERAL FEEDING VERSUS FEEDING AFTER PASSAGE OF FLATUS AFTER ABDOMINAL OPERATION”

BACKGROUND:Aperiod of nil per oral is a common practice after most abdominal surgeries because of postoperative ileus. But the ileus predominantly affects the stomach and colon. However, the small bowel recovers from the ileus within 4-6 hours after laparotomy. Postoperative period of ileus correlates well with patient's age, BMI and small bowel surgery and magnitude of surgery. Many patients come with diseases with vomiting and poor appetite leading to a state of malnutrition which is a common nding in preoperative patients requiring abdominal surgeries. It is well documented that length of hospital stay is prolonged in poorly nourished surgical patients. Keeping the patient nil per oral aggravates the malnutrition further in a state where the need of calorie is more with postoperative stress. The early postoperative feeding is established to be safe and well tolerated. Most of the early enteral feeding study concentrates on a single surgery. Hence, it is decided to include all the abdominal procedures including elective and emergency, open and minimal invasive, benign and malignant to have an overall view of efcacy of early enteral feeding in these patients.

Patient, carer and healthcare professional perspectives on increasing calorie intake in Amyotrophic Lateral Sclerosis.

Research suggests that higher Body Mass Index is associated with improved survival in people with Amyotrophic Lateral Sclerosis (pwALS). Yet, understanding of the barriers and enablers to increasing calorie intake is limited. This study sought to explore these issues from the perspective of pwALS, informal carers, and healthcare professionals. Interviews with 18 pwALS and 16 informal carers, and focus groups with 51 healthcare professionals. Data were analysed using template analysis and mapped to the COM-B model and Theoretical Domains Framework (TDF). All three COM-B components (Capability, Opportunity and Motivation) are important to achieving high calorie diets in pwALS. Eleven TDF domains were identified: Physical skills (ALS symptoms); Knowledge (about high calorie diets and healthy eating); Memory, attention, and decision processes (reflecting cognitive difficulties); Environmental context/resources (availability of informal and formal carers); Social influences (social aspects of eating); Beliefs about consequences (healthy eating vs. high calorie diets); Identity (interest in health lifestyles); Goals (sense of control); Reinforcement (eating habits); and Optimism and Emotion (low mood, poor appetite). To promote high calorie diets for pwALS, greater clarity around the rationale and content of recommended diets is needed. Interventions should be tailored to patient symptoms, preferences, motivations, and opportunities.

Clinical Outcomes of Home-Based Palliative Care: An Advance Illness Management Program

Prior studies have reported evidence that patients with chronic medical conditions benefit from home-based palliative care to manage symptoms. The purpose of this study is to evaluate the efficacy of an advanced illness management program provided by a visiting nurse agency. This program aims to reduce the burden of illness and to manage symptoms of patients who have difficulty leaving their home due to severity of their medical conditions. Data for this study were collected from patients who received home-based palliative care from the agency. Although the program has enrolled close to 500 patients from 2016 to 2019, the analytic sample for this study was restricted to patients enrolled between 2018 – 2019 who completed both baseline and follow-up assessments for three measures: Rapid Geriatric Assessment, Integrated Palliative Care Outcome Scale-Patient Version (IPOS), and Brief Illness Perception Questionnaire (BIPQ; N=96, capturing 33.8% of eligible patients). Paired sample t-tests were used to compare the symptoms and health outcomes between baseline and follow-up assessments. Average age of the participants were 79.9 years. Results from the RGA measure showed that patients’ scores on frailty and sarcopenia were significantly lower at follow-up, indicating improvement. Comparison of scores between baseline and follow-up on the IPOS measure showed that patients experienced improvement in the following symptoms: pain, weakness, nausea, poor appetite, constipation, sore/dry mouth, drowsiness, and mobility. Findings suggest that palliative care services can effectively managed the symptoms and health outcomes of homebound chronically ill patients. Other implications include reduced emergency room visits and hospital admissions.

A cross-sectional assessment of symptom burden among patients with advanced cervical cancer

BackgroundThe increasing burden of chronic non-communicable diseases in developing countries is driving attention to palliative care services. Identification of disease-specific symptoms of concern and their prevalence will guide designing, monitoring, and evaluating palliative care programmes. This study assessed the burden of symptoms and problems among patients with advanced cervical cancer.MethodsThis research followed a cross-sectional study design to quantitatively review the symptom burden among patients diagnosed with advanced cervical cancer attending treatment at Tikur Anbessa Specialised Hospital, Addis Ababa, Ethiopia from January to July 2019. Symptoms were assessed using a patient-reported, seven-day recall Integrated Palliative Care Outcome Scale (IPOS) version III. Frequency, median and mean scores with a standard deviation were used in the descriptive analysis whereas t-test and one-way analysis of variance were used for comparisons.ResultsThere were 385 patients with advanced cervical cancer, stage IIB-IVB, successfully interviewed. The median age was 50 years, the majority were illiterate (63.1%) and in marital union (62.3%). Over 50% of the patients experienced pain, weakness, poor appetite, constipation, limited mobility, and dry mouth. The burdens of emotional symptoms such as patient anxiety, family anxiety, and patient depression were also prevalent at 79.7%, 82.3%, and 47.0%, respectively. Patients who are illiterate, at a higher stage of the disease, not currently in marriage, and who received palliative radiotherapy bear a higher symptom burden.ConclusionPatients with advanced cervical cancer bear a high symptom burden. Early initiation of palliative care is recommended to alleviate the concerning symptoms, and to improve patients’ quality of life.

Associations of the oral microbiota and Candida with taste, smell, appetite and undernutrition in older adults

Poor taste and smell function are widely thought to contribute to the development of poor appetite and undernutrition in older adults. It has been hypothesized that the oral microbiota play a role as well, but evidence is scarce. In a cross-sectional cohort of 356 older adults, we performed taste and smell tests, collected anthropometric measurements and tongue swabs for analysis of microbial composition (16S rRNA sequencing) and Candida albicans abundance (qPCR). Older age, edentation, poor smell and poor appetite were associated with lower alpha diversity and explained a significant amount of beta diversity. Moreover, a lower Streptococcus salivarius abundance was associated with poor smell identification score, whereas high C. albicans abundance seemed to be associated with poor smell discrimination score. In our population, neither the tongue microbiota, nor C. albicans were associated with poor taste or directly with undernutrition. Our findings do suggest a host-microbe interaction with regard to smell perception and appetite.

Fever and Abdominal Pain in a 10-year-old with Autism.

Fever and Abdominal Pain in a 10-year-old with Autism.

Appetite as a predictor of malnutrition in end-stage renal disease patients in Saudi Arabia.

Patients with chronic kidney disease (CKD) undergoing hemodialysis (HD) are at high risk for malnutrition. This study aimed to 1) Investigate the prevalence of malnutrition among CKD patients undergoing maintenance HD; 2) Assess level of knowledge and appetite among patients; 3) Identify potential predictors of malnutrition. This cross-sectional study included 71 CKD patients on HD who were recruited from two principal outpatient dialysis centers located in Jeddah, Saudi Arabia. Data were collected using an interviewer-administered questionnaire which included sociodemographic and health characteristics, nutritional status (assessed using the Patient-Generated Subjective Global Assessment [PG-SGA]), biochemical data, nutritional knowledge, and appetite status (assessed using Council of Nutrition Appetite Questionnaire [CNAQ]). Forty-four percent of patients included in this study were malnourished, and over half of the patients had limited nutritional knowledge and appetite. Hemoglobin level and the CNAQ score were found to be independently negatively associated with the PG-SGA score (B: -1.03 [95% confidence interval (CI): -1.99, - 0.08] and B: -0.37 [95% CI: -0.64, -0.11], respectively). Renal healthcare professionals should assess the nutritional status of HD patients and identify barriers to adequate nutrition. Patients with poor appetite should specifically be targeted for nutrition-focused evaluation and management.

Analysis of cases of gastrostomia in children at different age periods

Rationale: Children with dysphagia have poor or selective appetite and, as a result, progressive malnutrition. In case of progression of symptoms of dysphagia, the question arises of staging a gastrostomy.

Clinical Effect of Auricular Point Sticking in Patients with Lung Cancer Receiving Chemotherapy

Objective: To discuss and analyze the clinical effect of auricular point sticking in lung cancer chemotherapy. Methods: Sixty-two patients with lung cancer treated with chemotherapy in Suqian Traditional Chinese Medicine Hospital of Jiangxi Province were selected for case evaluation and analysis. The time span of the research was from June 2020 to June 2021. The patients were divided into two groups: a study group (n = 31) and a control group (n = 31) based on their medical record numbers. All the patients were treated with conventional western medicine before and after chemotherapy to prevent adverse reactions; however, the patients in the study group were also treated with auricular point sticking in addition to the former. The relevant indexes of the two groups were compared. Results: The incidence of adverse reactions was significantly lower in the study group compared to the control group (P < 0.05); the rate of symptomatic relief of the patients in the study group was higher than that of the control group (P < 0.05); the stress response indexes toward chemotherapy of the study group were better than those of the control group (P < 0.05). Conclusion: Auricular point sticking for patients with lung cancer who are receiving chemotherapy can reduce the incidence of adverse reactions, alleviate clinical symptoms, such as chest distress, asthma, and poor appetite, significantly alleviate stress response caused by chemotherapy, as well as promote the treatment effect; thus, it is worthy of promotion.

Prevalence and factors associated with undernutrition among Dayak children in rural areas of Sarawak, Malaysia

Background: Undernutrition among children has become a major public health issue due to the high risk of morbidity and mortality involving this vulnerable age group. This study focused on the rural population, especially among the Dayak children in Sarawak, Malaysia. Methodology: This community-based cross-sectional study was conducted in Sarawak’s rural areas using a multistage stratified cluster sampling technique. Data were collected through face-to-face interviews using an interviewer-guided questionnaire. The nutritional status of the under-five children was measured according to the World Health Organization guidelines. The nutritional indicators were calculated as z-scores. Multivariate logistic regression analyses were performed using SPSS to identify the factors associated with nutritional status. Results: The prevalence of undernutrition among the under-five Dayak children in the rural areas of Sarawak was 39.6%. The analysis suggested that wasting was predominantly associated with parental education levels of primary and below, poor wealth index, environmental and sanitation issues, children with history of low birth weight, shorter duration of exclusive breastfeeding, and poor appetite. Stunting was high within the age group of <3 years old and was associated with parents’ occupation and household wealth index. Low parental education, poor wealth index, environmental and sanitation issues, poor appetite, and the children’s recent illness predicted underweight. Conclusion: These findings imply that a multi-sectoral and multi-dimensional approach is essential to address undernutrition in rural settings. Improvement on households’ socioeconomy, environment and sanitation should be emphasised to reduce undernutrition among the children.

COVID-19 Restrictions and Maternal Experience and Infant Feeding

The Movement Control Order (MCO), also known as the partial lockdown, was introduced in Malaysia in March 2020 to combat the COVID-19 pandemic, changing many public sector protocols and regulations. This may have implications for neonatal and maternity care and services, especially among new mothers. The aim of this study was to compare the postnatal experiences and feeding practices between mothers who gave birth before MCO (B-MCO) and during MCO (D-MCO). One thousand fifty-one mothers with an infant under 18 months in Malaysia completed an online survey between July 2020 and October 2020. The survey advertisement was disseminated online via various social media platforms. More D-MCO mothers faced a significant effect on the ability to pay rent/mortgage, with their spouses facing a higher impact on employment. D-MCO mothers were more likely to have changed their birth plans, perceived insufficient breastfeeding support, and experienced changes in postnatal services since MCO. In contrast, more B-MCO mothers had stopped breastfeeding during the MCO and started complementary feeding earlier than planned. Many mothers reported feeling down and lonely and having trouble sleeping and a poor appetite. D-MCO mothers had more time to focus on their health, whereas B-MCO mothers spent more time outdoors. MCO affected mothers' livelihood and postnatal experiences, potentially causing emotional distress. Hence, improved breastfeeding support, particularly at birth, is recommended, as is routine mental health screening during the postnatal checkup. Furthermore, because online contact was readily accessible during the pandemic, the efficacy of online breastfeeding support should be evaluated.

Utility of a Patient-Reported Symptom and Functioning Assessment Tool for Geriatric Oncology Care in China

ObjectivesSymptom and functional assessment is challenging in geriatric oncology care. This multicenter cross-sectional study examined the use of a multiple-symptom assessment tool, the MD Anderson Symptom Inventory (MDASI), on Chinese patients with cancer aged 65 years and older. MethodsPatient-rated symptoms and functioning were assessed using MDASI and the European Organization for Research and Treatment of Cancer quality-of-life questionnaire. ResultsThe most severe symptoms were fatigue and poor appetite. The older group (75-84 years old, n = 224) reported a more severe difficulty remembering (effect size [ES] 0.32; P < .001), shortness of breath (ES 0.20; P = .020), and interference with general activity (ES 0.14; P = .027), with significantly worse physical functioning (ES −0.33; P < .001) and cognitive functioning on the European Organization for Research and Treatment of Cancer quality-of-life questionnaire (ES 0.20; P < .001) than the younger group (65-74 years old, n = 555). For MDASI measures of the core symptoms and total interference with daily activity, Cronbach α coefficients were 0.90 and 0.93, respectively, for the younger group; and 0.93 and 0.94 for the older group, respectively. Moderate to severe (score ≥4) interference with general activity and walking on MDASI accurately indicated poor performance status (area under the curve 0.8089 and 0.7969, respectively) and lack of independence status of Activities of Daily Living (area under the curve 0.7993 and 0.8304, respectively). ConclusionsMDASI is psychometrically reliable, valid, and clinically sensitive for the measuring symptom burden and functional status of Chinese patients with cancer aged 65 years and older. MDASI could be adopted to measure multiple symptoms and physical functioning outcomes in geriatric oncology practice as well as for research on treatment benefits.

Poor appetite in dogs A potentially common symptom of gall bladder disease

Poor appetite in dogs A potentially common symptom of gall bladder disease

Innovative plAnt Protein fibre and Physical activity solutions to address poor appEtite and prevenT undernutrITion in oldEr adults – APPETITE

AbstractOlder adults with poor appetite are at higher risk of undernutrition due to the role of appetite as a key driver of food intake. Dietary protein and fibre are critical nutrients in this population, and enhancing their intake is vital to preventing undernutrition and maintaining organ function and health. In APPETITE, a transdisciplinary consortium of experts from eight institutions in six European countries will collaborate to design potentially effective interventions to enhance protein and fibre consumption of community‐dwelling older adults with poor appetite, thereby addressing undernutrition through a targeted nutrition‐ and physical activity‐based strategy. Older adults with poor appetite will first be evaluated using a mixed‐methods approach to gain insights into their nutritional and behavioural preferences. Working with this target group, innovative, acceptable and affordable food products will be developed that combine several domestic plant proteins and dietary fibres. Mechanistic insights will be gained by examining the impact of selected products and physical activity on digestibility, amino acid bioavailability and whole‐body protein metabolism. In a multi‐country, randomised controlled intervention trial, the impact of two new food products, provided as part of a personalised diet, a physical activity programme, and their combination will be determined. APPETITE will improve our understanding about plant‐based protein and fibre products and their metabolic and clinical effects. It will create new knowledge about how these products can be combined in a whole‐diet approach, together with physical activity and regular social contacts, to overcome undernutrition and to contribute to a better quality of life for older Europeans.

Kidney cyst

H., 58 years old, was admitted to the therapeutic department on 17 / XI-61 due to suspected splenomegaly. Complains of abdominal pain, fever, severe headache, severe weakness, poor appetite. A tumor in the abdomen on the left was first noticed 4 years ago. At first, the tumor did not cause significant disturbances. From 4 / XI-61, for no apparent reason, the tumor began to grow, there were pains in the abdomen, and the temperature rose.

Swarna Prashana - faith in the embrace of research.

Childhood needs diverse nutritional requirements. Poor appetite, lifestyle changes, and poor digestion affects child immunity and make them prone to diseases. Kaumarabhritya, a branch of Ayurveda which deals in child and adolescent health care, has a unique concept of Swarna Prashana (SP) to promote generalized immunity and intellect. SP is commonly recommended to children between 0 and 12 years of age and given as a general health promoter to improve intellect, digestion, strength, immunity, longevity, and complexion. Multiple benefits of SP are mentioned in different Samhitas which needs to be explored on scientific background. Authors have highlighted content variabilities, plausible mechanisms, research tasks and potentials, lacunae, and future prospects about SP. This manuscript is a spotlight on current social, clinical, marketing, and scientific information of Swarna Prashana. SP can be a cost-effective, safe, infrastructure compatible, and prevention-centric approach to improve children's overall health status and has the potential to serve as a positive health care program for children.

Cannabis and complementary/alternative self-treatment approaches for symptom management among African American persons living with HIV

ABSTRACT Persons living with HIV (PLWH) experience symptoms from disease progression and side effects of antiretroviral treatment. This study examines in African American PLWH (N = 259) commonly-endorsed symptoms, types and self-rated efficacy of therapies for symptom alleviation. Analyses were stratified by gender (n = 178 males, n = 81 females) and cannabis use typology: non-users (n = 90), mostly recreational use (n = 46), mixed recreational/therapeutic use (n = 51), or mostly therapeutic use (n = 72). Females reported greater severity for pain, fatigue, depression, weight change and tingling in extremities, but there were no gender differences for ratings of poor sleep, anxiety, poor appetite, or headache. Both marijuana (used therapeutically by females more than males) and medication(s) were among the 3 top methods for managing pain, poor sleep, anxiety, and headache. Marijuana was most often used for poor appetite, and medications for depression. Perceived efficacy of self-treatment approaches was moderately good. Among African American PLWH, symptom severity was higher for females and for therapeutic users of cannabis. Marijuana and medicine were often used to self-treat symptoms, but many participants did nothing. These results highlight the need for careful evaluation and management of symptoms in this underserved population.

November 2021 Imaging Case of the Month: Let’s Not Dance the Twist

No abstract available. Article truncated after the first 150 words. History of Present Illness: An 82-year-old man presented to his physician for general health maintenance as well as a complaint of persistently poor quality sleep and poor appetite with weight loss. The patient had undergone robotic-assisted radical left nephroureterectomy and cystectomy with pelvic lymph node dissection and urinary diversion for left clear cell renal cell carcinoma (staged T2a, grade 2) and transitional cell carcinoma of the bladder (carcinoma in situ at surgery), approximately 9 months earlier. The patient’s bladder malignancy was initially treated with transurethral resection, with histopathology at that procedure showing high-grade papillary urothelial malignancy with lamina propria invasion, but no muscular invasion; this procedure was followed by formal complete resection approximately 3 months later. The patient’s post-operative course was complicated by significant bleeding which required transfusion of 3 units of blood. He had undergone inferior vena caval filter placement prior to surgery when preoperative testing revealed lower extremity …

Pulmonary tuberculosis and the Gerson's diet

Dr. B. Gettkant, director of the Schneberg tuberculosis sanatorium, also deals with pulmonary tuberculosis and the Gerson's diet (D. m. W. 1929, no. 43). Observing 20 severe pulmonary tbc patients, Gettkant came to the conclusion that in no case did the Gerson's diet affect the course of pulmonary TBK: 11 out of 20 people died, 8 remained inoperative, the process went ahead and the fate of 1 remained unknown; with the Gerson's diet there is undoubtedly an improvement in lupus, in bone and articular TBK, but not in pulmonary. As a great difficulty in carrying out a diet a. indicates the absence of salt: the TBC b-th already have a poor appetite, and desalted food, despite its best preparation, soon arouses disgust, and the b-th's appetite still falls.