Recent Weight Loss Research Articles

Dietary restraint and weight loss as risk factors for eating pathology

Measures of dietary restraint do not consistently predict caloric restriction, and these scales appear inadequate for differentiating between healthy and risky restraint in individuals. The current study examined the relationship between self-reported dietary restraint, recent weight loss, body mass index (BMI), and eating pathology in a college sample to determine if dietary restraint coupled with caloric restriction would prove to be a more sensitive marker of eating disorder risk than restraint alone. Participants (N=245) completed a series of measures evaluating dietary restraint, recent weight loss, and eating habits. Results suggested that dietary restraint related most consistently to eating pathology, with more nuanced results for women regarding the relations between dietary restraint, recent weight loss, and BMI. Findings provided further evidence that dietary restraint and weight loss may relate to eating pathology through independent pathways. In addition, recent weight loss may be a relevant risk factor for women at lower current BMI.

The use of commitment techniques to support weight loss maintenance in obese adolescents

Objectives: Obesity is a rising problem in adolescents related to unhealthy behaviours. Commitment devises are one type of behavioural intervention that may help people change their behaviours. The current pilot trial tests whether commitment devices delivered via text message help adolescents maintain their recent weight loss.Methods: During a 12-week pilot trial, adolescents who attended a weight loss camp were randomly assigned to either received text messages that contained only information, i.e. advice, about weight loss management (n = 13) or asked for them to commit to following the same advise (n = 14).Results: The BMI of the adolescents in the commitment group did not change. In contrast, the BMI of adolescents in the information group increased. A linear regression revealed that group was a significant predictor of BMI change. A logistic regression revealed that adolescents in the information group were nearly eight times more likely to regain weight than those in the commitment group.Conclusions: This is the first study with adolescents to show weight maintenance using a commitment device. The results suggest that commitment devices can help adolescents maintain their recent weight loss.

Preoperative Frailty Is Associated With Discharge to Skilled or Assisted Living Facilities After Urologic Procedures of Varying Complexity

To evaluate the association between frailty and postoperative discharge destination after different types of commonly performed urologic procedures in older patients. Using data from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) from 2011 to 2013, we identified commonly performed inpatient urologic procedures among patients aged 65 and older. We then assessed the effect of frailty, measured by the NSQIP Frailty Index (NSQIP-FI), on discharge to a skilled or assisted living facility using logistic regression and assessed the heterogeneity of this effect across procedures using 2-level random effects modeling. Overall, 1144 out of 20,794 (5.5%) urologic cases, representing 19 different procedures, resulted in discharge to a skilled or assisted living facility. Cystectomy and large transurethral resection of bladder tumor had the highest percentage (16.3%). Twenty-five percent of patients undergoing urology procedures were frail (NSQIP-FI 0.18+), including 9.8% of patients discharged to a facility. Even after adjustment for year, age, race, type of anesthesia, smoking status, recent weight loss, and whether or not the procedure was elective, frailty was strongly associated with discharge to a facility (adjusted odds ratio 3.1 [96% confidence interval 2.5, 3.8] for NSQIP-FI 0.18+ compared to NSQIP FI 0). This finding was consistent across most procedures of varying complexity with an overall effect of odds ratio 1.6 (95% confidence interval 1.5, 2.0). Increasing frailty is associated with discharge to a skilled or assisted living facility across most inpatient urologic procedures evaluated, regardless of complexity. This information is important for preoperative counseling with patients undergoing urologic surgery.

Perfil clínico-epidemiológico de pacientes portadores de tuberculose atendidos em uma unidade municipal de saúde de Belém, Estado do Pará, Brasil

Objetivou-se identificar o perfil clinico-epidemiologico dos pacientes portadores de tuberculose atendidos em uma unidade municipal de saude de Belem, Estado do Para, Brasil. Trata-se de estudo observacional, quantitativo e descritivo. Obtiveram-se 102 prontuarios como amostra total que foram analisados por um instrumento de coleta de dados de autoria propria. Os dados encontrados foram tabulados pelo programa Microsoft Excel 2010. Dos prontuarios analisados, foram identificados individuos com idade media de 35,39 ± 14,39 anos, sendo 54,90% dos casos de tuberculose registrados no sexo masculino e 97,06% eram casos de procedencia urbana. Quanto ao estado civil, 63,73% dos pesquisados eram solteiros, 49,02% considerados da raca parda e 33,35% tinham o ensino fundamental incompleto. Em relacao as variaveis clinicas, 69,60% dos individuos diagnosticados com tuberculose nao possuiam o habito de tabagismo e 78,44% relatavam perda de peso recente. A forma clinica de tuberculose mais prevalente foi a do tipo pulmonar (82,35%), com BAAR positivo (64,71%) e GRAM 3+. Observou-se que a tuberculose ainda se faz muito frequente em nossa regiao, mesmo sendo uma doenca milenar, ainda apresenta afeccao crescente em muitos individuos na atualidade, sendo necessaria a realizacao de estrategias para minimizar os indices da doenca.

Frailty and postoperative outcomes in patients undergoing surgery for degenerative spine disease

Background ContextFrailty is defined as a state of decreased reserve and susceptibility to stressors. The relationship between frailty and postoperative outcomes after degenerative spine surgery has not been studied. PurposeThis study aimed to (1) determine prevalence of frailty in the degenerative spine population; (2) describe patient characteristics associated with frailty; and (3) determine the association between frailty and postoperative complications, mortality, length of stay, and discharge disposition. Study DesignThis is a retrospective analysis on a prospectively collected cohort from the National Surgical Quality Improvement Program (NSQIP). Patient SampleA total of 53,080 patients who underwent degenerative spine surgery between 2006 and 2012 were included in the study. Outcome MeasuresA modified frailty index (mFI) with 11 variables derived from the NSQIP dataset was used to determine prevalence of frailty and its correlation with a composite outcome of perioperative complications as well as hospital length of stay, mortality, and discharge disposition. MethodsAfter calculating the mFI for each patient, the prevalence and predictors of frailty were determined for our cohort. The association of frailty with postoperative outcomes was determined after adjusting for known and suspected confounders using multivariate logistic regression. ResultsFrailty was present in 2,041 patients within the total population (4%) and in 8% of patients older than 65 years. Frailty severity increased with increasing age, male sex, African American race, higher body mass index, recent weight loss, paraplegia or quadriplegia, American Society of Anesthesiologists (ASA) score, and preadmission residence in a care facility. Frailty severity was an independent predictor of major complication (OR 1.15 for every 0.10 increase in mFI, 95%CI 1.09–1.21, p<.0005) and specifically predicted reoperation for postsurgical infection (OR 1.3, 95%CI 1.16–1.46, p<.0005). Prolonged length of stay and discharge to a new facility were also independently predicted by frailty severity (p<.0005). Frailty severity predicted 30-day mortality on unadjusted (OR 2.05, 95%CI 1.70–2.48, p<.0005) and adjusted analyses (OR 1.48, 95%CI 1.18–1.86, p<.0005). ConclusionsFrailty is an important predictor of postoperative outcomes following degenerative spine surgery. Preoperative recognition of frailty may be useful for perioperative optimization, risk stratification, and patient counseling.

Risk factors associated with malnutrition in hospitalized patients

ABSTRACT Objective To identify factors associated with malnutrition in patients hospitalized in general public hospitals of the city of Manaus, Amazonas, Brazil. Methods This cross-sectional study included 397 patients of both sexes aged more than 18 years, staying at three public hospitals in Manaus, Amazonas. The patients were submitted to anthropometric and subjective global assessments, the latter being the main diagnostic method. For association analyses between malnutrition (dependent variable) and other covariates, we used contingency table for variable selection and multiple logistic regression for independent effect test between exposure and outcome. The strength of association between the variables was expressed as odds ratio, with a 95% confidence interval. The analyses were performed by Epi Info 7.0. Results Among the risk factors associated with hospital malnutrition, hospital stays longer than 15 days, when analyzed alone, nearly tripled the odds of malnutrition. However, in the final model, the variables that remained associated were: persistent change in diet, presence of gastrointestinal symptoms, recent weight loss, weight loss in the last six months, cancer, and age higher than 60 years. Conclusion Malnutrition is recurrent in hospitals, and the factors associated with malnutrition can be identified on admission, allowing adequate monitoring during hospital stay. Therefore, a more effective performance of nutritional screening and monitoring programs is critical.

Pulmonary Paracoccidioidomycosis: A Case Report

Introduction: Paracoccidioidomycosis (PCM) is a type of mycosis most often found in the lung. The authors present a case of pulmonary PCM. Case Presentation: A 72-year-old man had a four-year history of dyspnea, dry cough, and weakness and a recent weight loss of more than 10 kg. First, he was treated with glucocorticoid, but he did not continue this treatment. Core needle biopsy was done. Pathology reported paracoccidioidomycosis. The patient was treated with itraconazole. Conclusions: PCM has not been reported in Iran until now, but it should be considered as a differential diagnosis when risk factors or symptoms of PCM are detected.

Case report: a student of Asian origin with Pott’s disease

We describe a case report of a student of Asian origin who presented with fever of unknown origin, cough, recent onset low back pain and weight loss. Initial physical examination was unremarkable. Laboratory results showed inflammation, but extensive testing for bacteriological and viral serology was negative. While the chest Computed Tomography (CT) scan did not show any abnormal findings, pelvic CT scan revealed an osteolytic sacral mass, with extension to the soft tissues and muscles, and concomitant nerve compression. An ultrasonography-guided puncture of the lesion eventually showed Mycobacterium tuberculosis, leading to the diagnosis of tuberculous spondylitis or Pott’s disease. The standard tuberculostatic treatment was applied during 9 months with a good clinical result. Skeletal tuberculosis is not common in Western countries and it can be overlooked in foreign patients with fever of unknown origin.

Risk Factors for Herpes Zoster Among Adults.

Background. The causes of varicella-zoster virus reactivation and herpes zoster (HZ) are largely unknown. We assessed potential risk factors for HZ, the data for which cannot be obtained from the medical sector.Methods. We conducted a matched case-control study. We established active surveillance in Olmsted County, Minnesota to identify HZ occurring among persons age ≥50 years during 2010–2011. Cases were confirmed by medical record review. Herpes zoster-free controls were age- and sex-matched to cases. Risk factor data were obtained by telephone interview.Results. We enrolled 389 HZ case patients and 511 matched controls; the median age was 65 and 66 years, respectively. Herpes zoster was associated with family history of HZ (adjusted odds ratio [aOR] = 1.65); association was highest with first-degree or multiple relatives (aOR = 1.87 and 3.08, respectively). Herpes zoster was also associated with prior HZ episodes (aOR = 1.82), sleep disturbance (aOR = 2.52), depression (aOR = 3.81), and recent weight loss (aOR = 1.95). Stress was a risk factor for HZ (aOR = 2.80), whereas a dose-response relationship was not noted. All associations indicated were statistically significant (P < .05). Herpes zoster was not associated with trauma, smoking, tonsillectomy, diet, or reported exposure to pesticides or herbicides (P > .1).Conclusions. We identified several important risk factors for HZ; however, the key attributable causes of HZ remain unknown.

Physical Activity and Sedentary Time in Primary Care Patients with Recent Intentional Weight Loss

Physical Activity and Sedentary Time in Primary Care Patients with Recent Intentional Weight Loss

Early mortality in lung cancer: French prospective multicentre observational study.

BackgroundDespite the progress seen in the last decade in diagnosis and treatment, lung cancer has still a bad prognosis and a substantial number of patients died within the weeks following diagnosis. The objective of this study was to quantify early mortality in lung cancer, to identify patients who are at high risk of early decease, and to describe their management in a real world.MethodsProspective observational study including consecutively all adult patients managed for primary lung cancer histologically or cytologically diagnosed in 2010 in the respiratory medicine department of one of the participating French general hospitals. Patients and cancer characteristics and first therapeutic strategy were collected at diagnosis. Dates of death were obtained from investigators or town council of the patient’s birth place. All fatal cases were considered regardless of the cause of the death. Multivariate logistic regression model was used to determine the factors significantly and independently associated with death at 1 and 3 months.ResultsSeven thousand fifty-one patients from 104 centres were included in the study. Vital status was obtained for 6,981 patients. Respectively, 678 (9.7 %) and 1,621 (23.2 %) of the 6,981 patients with available data died within 1 and 3 months following diagnosis. As compared with the other patients, they were significantly older and frailer (based on performance status [PS] and recent weight loss) and more frequently reported stage IV tumour. Overall, 64.5 % (1 month) and 42.8 % (3 months) of patients had no cancer therapy and less than 1 % were included in a therapeutic trial.ConclusionAbout one in four patients died within 3 months following lung cancer diagnosis. Early mortality mainly involves frail patients with advanced cancer and is associated with lack of cancer therapy. This supports the need for early diagnosis and clinical trials in this population. Reducing early mortality to give supplementary time to patients to organise the future is a major challenge for 21st century physicians.

Frailty and Postoperative Outcomes in Patients Undergoing Surgery for Degenerative Spine Disease

Introduction Frailty is defined as a state of decreased reserve and susceptibility to stressors. The relationship between frailty and outcomes after degenerative spine surgery has not been studied. Objectives (1) Determine prevalence of frailty in the degenerative spine population; (2) Describe patient characteristics associated with frailty; (3) Determine the ability of frailty to predict postoperative outcomes. Material and Methods We analyzed 52,671 patients in the National Surgical Quality Improvement Program who underwent degenerative spine surgery. A modified frailty index (mFI) was used to determine the prevalence and severity of frailty as previously described. The association of frailty with postoperative outcomes was determined using multivariate logistic regression. Results Frailty was present in 2,041 patients within the total population (4%), and 8% of patients older than 65 years. Frailty severity increased with increasing age, male sex, African-American race, higher body mass index, recent weight loss, paraplegia or quadriplegia, ASA score, and pre-admission residence in a care facility. Frailty severity was an independent predictor of major complication (OR 1.15 for every 0.10 increase in mFI, 95%CI 1.09–1.22, p &lt; 0.0005), and specifically predicted re-operation for post-surgical infection (OR 1.3, 95%CI 1.16–1.46, p &lt; 0.0005). Prolonged length of stay and discharge to a new facility were also independently predicted by frailty severity ( p &lt; 0.0005). Frailty severity predicted 30-day mortality on unadjusted (OR 2.05, 95%CI 1.69–2.47, p &lt; 0.0005) and adjusted analysis (OR 1.44, 95%CI 1.15–1.81, p &lt; 0.005). Conclusions Frailty is an important predictor of postoperative outcomes following degenerative spine surgery. Preoperative recognition of frailty may be useful for perioperative optimization, risk stratification and patient counseling.

Anterior Mediastinal Mass

An asymptomatic 47-year-old woman underwent a radiographic screening to rule out tuberculosis prior to volunteering at her local hospital. The incidental finding of a mediastinalmassprompteda referral to her primary carephysician,whoelicited from the patient some complaints of mild but worsening orthopnea that was exacerbated when she would lie down. She denied any recent weight loss, muscle weakness, or diplopia. Her surgical history was significant for having undergone a cesarean section. She denied any radiation exposure. A computed tomographic scanof the chestwas obtained (Figure, A), and thepatientwas referred to surgery for evaluation. A physical examination identified a midline trachea, no significant thyromegaly in theneck,nosignificant lymphadenopathy,andnoadditional significant findings.Thepatientwas taken to the operating room for surgery to remove themass (with gross findings as seen in Figure, B). Quiz at jamasurgery.com Computed tomographic scan of chest A Gross findings following sternotomy B

MP31-09 COMORBIDITY, DISABILITY, AND PARTIAL NEPHRECTOMY USE FOR OLDER PATIENTS WITH STAGE I KIDNEY CANCER

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Quality of Life and Shared Decision Making III1 Apr 2016MP31-09 COMORBIDITY, DISABILITY, AND PARTIAL NEPHRECTOMY USE FOR OLDER PATIENTS WITH STAGE I KIDNEY CANCER Hung-Jui Tan, Timothy Daskivich, Joseph Shirk, Christopher Filson, Mark Litwin, and Jim Hu Hung-Jui TanHung-Jui Tan More articles by this author , Timothy DaskivichTimothy Daskivich More articles by this author , Joseph ShirkJoseph Shirk More articles by this author , Christopher FilsonChristopher Filson More articles by this author , Mark LitwinMark Litwin More articles by this author , and Jim HuJim Hu More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1262AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The surgical risks notwithstanding, the long-term benefits of nephron-sparing may be maximized in patients with poorer health because of their propensity for progressive renal or cardiac disease. Accordingly, we sought to determine if receipt of partial nephrectomy (PN) for stage I kidney cancer varied with baseline comorbidity or disability. METHODS Using SEER-Medicare data from 2000-2009, we applied a validated, claims-based algorithm to identify patients treated with PN or radical nephrectomy (RN) for stage I kidney cancer. For each patient, we measured comorbidity with the Charlson comorbidity score and disability with function-related indicators (FRI), a collection of claims indicative of dysfunction (e.g., mobility-assist devices, falls). Pre-existing diabetes, hypertension, heart disease, and kidney disease were also classified. After comparing baseline characteristics, we evaluated trends in PN usage according to comorbidity and disability by applying logistic regression. Finally, we estimated the probability of PN using multivariable, mixed effects models adjusting for patient, surgeon, and hospital characteristics. RESULTS Overall, 2,956 of 11,678 patients (25.3%) underwent treatment with PN. Receipt of PN was associated with younger age, male gender, higher socioeconomic position, smaller tumor size, and treatment by a high-volume provider, cancer center, or academic institution (p<0.001). During the study period, PN utilization increased significantly (p<0.001) but did not differ according to comorbidity or disability (Figure). Adjusting for patient, surgeon, and hospital characteristics, the predicted probability of PN stood at 22.2%, 22.8%, and 19.6% for patients with Charlson scores of 0, 1, and 2+, respectively. For patients with FRI counts of 0, 1, and 2+, the probability of PN was 21.8%, 22.6%, and 20.3% respectively. Only history of kidney disease appeared to be linked to PN use (OR 1.49, 95% CI 1.33-1.66). CONCLUSIONS In this population, the increasing use of PN did not vary with respect to patient comorbidity or disability. As the potential benefits of PN differ according to a patient's underlying health status, selection tools and algorithms that match treatment to patient comorbidity or function may be needed to optimize kidney cancer care in the US. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e422 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Hung-Jui Tan More articles by this author Timothy Daskivich More articles by this author Joseph Shirk More articles by this author Christopher Filson More articles by this author Mark Litwin More articles by this author Jim Hu More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Vegetable protein intake is associated with lower gallbladder disease risk: Findings from the Women's Health Initiative prospective cohort

ObjectiveThis study aimed to measure associations between gallbladder disease and protein intake patterns, separated by quantity and type (vegetable vs. animal), among postmenopausal women. MethodsAnalyses were based on 130,859 postmenopausal women enrolled from 1993 to 1998 at 40 U.S. clinical centers in the Women's Health Initiative clinical trials and observational study. Women were excluded if they reported a history of gallbladder disease prior to baseline. Cox proportional hazards regression models, adjusted for gallbladder disease risk factors, were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between energy-adjusted protein intake and gallbladder disease. ResultsIn this study sample, 8.1% of postmenopausal women self-reported incident gallbladder disease. In multivariate analysis, women in the highest quintile of energy-adjusted vegetable protein intake (>24.0g/d) had a lower risk of gallbladder disease (HR, 0.87; 95% CI, 0.81–0.93) as compared to women in the lowest quintile (<16.3g/d) (Ptrend<0.001). Total protein intake was modestly protective against gallbladder disease (Ptrend<0.021). Animal protein intake was not associated with gallbladder disease risk. The protective effect of vegetable protein held stable only for women without history of diabetes (HR, 0.86; 95% CI, 0.80–0.92) and without recent weight loss (HR, 0.88; 95% CI, 0.80–0.97). ConclusionsVegetable protein intake is inversely associated with gallbladder disease risk in our sample of postmenopausal women. In addition to weight management, healthcare providers could emphasize vegetable protein as an additional dietary modality to promote lower risk for gallbladder disease.

Risk factors for infectious readmissions following radical cystectomy: results from a prospective multicenter dataset.

Radical cystectomy (RC) is the gold standard treatment for muscle-invasive bladder cancer. This procedure has a high rate of perioperative complications, many of which are infectious in nature. The objective of our study was to evaluate demographic, intrinsic and extrinsic patient variables associated with developing readmission within 30 days due to infectious complications following RC. We acquired data available from the American College of Surgeons National Surgical Quality Improvement Program. We queried this dataset to identify all patients who underwent RC for muscle-invasive malignant disease (CPT 188.x) in 2012 based on CPT coding. Logistic regression analysis was used to investigate the relationship between preoperative variables and readmissions for infectious complications. Of the 961 patients undergoing cystectomy for malignancy, 159 (17%) required readmission for any indications at a median of 16 days (interquartile range 13-22 days) postoperatively. We identified 71 of a total of 159 (45%) readmissions, which were due to infectious complications. Smoking was more prevalent in the patient population readmitted for an infectious complication compared with the patient population readmitted for a non-infectious complication (37% versus 25%; p = 0.03). Using logistic regression analysis smoking was associated with a significant risk for readmission due to an infectious cause (odds ratio 2.28, 95% confidence interval 1.82-2.97, p = 0.02). Readmission due to an infectious etiology was not associated with other perioperative factors including type of urinary diversion, sex, duration of operation, hypertension, or recent weight loss. Readmission following RC is a common occurrence and infectious complications drive readmission in almost half of the cases. Current smoking was the only independent risk factor for an infectious readmission. Counseling patients in smoking cessation prior to the procedure may provide an avenue for quality improvement to limit readmissions.

Risk Factors for Short-term Complications of Anterior Cruciate Ligament Reconstruction in the United States

Background: Anterior cruciate ligament reconstruction (ACLR) is a commonly performed procedure that is highly successful in restoring knee stability and function. The incidence of early ACLR complications and the risk factors for these complications are not well defined. Purpose: To determine the incidence of 30-day complications and patient and surgical risk factors for complications after ACLR. Study Design: Cohort study; Level of evidence, 3. Methods: Patients who underwent ACLR between 2005 and 2013 were identified in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database using Current Procedural Terminology billing codes. Postoperative complications in the 30-day period after surgery were identified. Potential patient and surgical risk factors for 30-day complications after ACLR were analyzed using univariate and multivariate analyses. Results: A total of 4933 patients were identified. Major complications occurred in 27 patients (0.55%), and minor complications occurred in 43 patients (0.87%), with overall complications occurring in 66 patients (1.34%). The most common complications were symptomatic deep venous thrombosis requiring treatment (n = 27; 0.55%), return to the operating room (n = 18; 0.36%), superficial infections (n = 10; 0.20%), deep infections (n = 7; 0.14%), and pulmonary embolism (n = 6; 0.12%). A single mortality (0.02%) occurred. Multivariate analyses demonstrated that smoking, dyspnea, a history of chronic obstructive pulmonary disease, and recent weight loss were all risk factors for the development of overall complications, although in combination, these factors accounted for only 3% of the variance in the complication rate. Conclusion: ACLR has a low incidence of complications (1.34%) in the early postoperative period, with the most common being symptomatic venous thromboembolic disease requiring treatment, return to the operating room, and infections. Because ACLR is an elective procedure, surgeons should use this information to counsel patients on risks and to guide their decision making about patient selection.

Erratum to: Determinants of acute malnutrition among children aged 6–59 months in Public Hospitals, Oromia region, West Ethiopia: a case–control study

Acute malnutrition is a recent and severe weight loss as a result of acute food shortage and/or illness. It is the leading causes of morbidity and mortality of children aged 6–59 months as risk of death is nine times higher than that of children without it. In Ethiopia despite recent economic progress; nutritional status of children is among the worst in the world and it remains major public health problem. According to recently published mini demographic & health survey 2014; 9 % of children are wasted (3 % severely wasted) in the country and in Oromia region 8.8 % of children are wasted (1.7 % severely wasted). However there is no information on determinants of acute malnutrition in the study area. The aim of this study was to identify determinants of acute malnutrition among children aged 6–59 months in the study area. A facility based un-matched case control study was conducted on 339 (113 cases and 226 controls) children aged 6–59 months with their respective mothers from December 3, 2014 to March 25, 2015. The data were collected by using a pre-tested structured questionnaire and mid upper arm circumference (MUAC). Odds Ratio along with 95 % confidence interval was estimated to identify determinants of acute malnutrition (wasting) using the multivariable logistic regression. Level of statistical significance was declared at P < 0.05. Wasting was associated with diarrheal diseases in the previous two weeks [AOR (95 % CI) =3.94 (2.01–7.73)], mothers habit of less frequent hand washing [AOR (95 % CI) =14.39 (7.33–28.22)], did not exclusively breastfed [AOR (95 % CI) = 2.63 (1.29–4.82)], having large family sizes [AOR (95 % CI) =2.59 (1.34–5.0)], absence of latrine [AOR (95 % CI) =2.99(1.23–7.06)], illiterate mothers [AOR (95 % CI) =2.16(1.14–4.11)] and febrile illness in the previous two weeks [AOR (95 % CI) =1.89 (1.0–3.59)]. Wasting was significantly associated with diarrheal and febrile illness in the previous two weeks, lack of maternal education, hand washing & sub optimal breastfeeding practices, larger family size, and absence of latrine. Thus, an organized effort should be made at all levels to improve maternal and child health services, hand washing & breastfeeding practices, construction of latrines and education of mothers to restrain the problems of child acute malnutrition.

La tumeur brune : cause exceptionnelle de lombo-cruralgie à évolution favorable

IntroductionWe report a case of a particular lumbar and radicular pain revealing primary hyperparathyroidism and discuss its characteristics through a literature review. Case reportA 55-year-old woman was hospitalized for a nerve root pain associated with recent weight loss with normal physical examination. Biology showed no evidence for acute phase response and normal kidney and liver functions. However, hypercalcemia and hypophosphatemia were evidenced. Radiographs of the lumbar spine showed a lytic lesion occupying the body of L4. A lumbar spine CT scan confirmed the presence of a compressive nerve root brown tumor. High level of PTH and parathyroid mass raised the possibility of the diagnosis of primary hyperparathyroidism. After parathyroidectomy all signs of hyperparathyroidism resolved with complete disappearance of spinal brown tumors in a two year follow-up CT scan. ConclusionAlthough uncommon, brown tumor should be a diagnosis to consider in their presence of a spinal tumor. The improvement after conservative treatment could be dramatic.

Impacto na qualidade de vida de portadores de Doença de Parkinson com risco para disfagia

Objective. To evaluate the impact on the quality of life of patients whit parkinson’s disease with risk of dysphagia. Method. This study included patients with DP with risk of dysphagia who attended at the movement disorders clinic from a hospital in Porto Alegre. With dis­ease staging according to the Hoehn &amp; Yahr scale for disease severity; answered a Speech Therapy questionnaire, EAT-10 questionnaire and SWAL-QOL questionnaire. Results. The sample consisted in 25 pa­tients: 16 (64%) male. The average age was 64.5 and the average dis­ease duration was 11 years. 18 (72%) participants had H&amp;Y between 2 and 3. The correlation between the SWAL-QOL and the Speech Therapy questionnaire were correlated with tiredness area and recent weight loss (p=0.01), change in the food consistency (p=0.015), cur­rent consistency ingested (p=0.02) and oral phase alteration (p=0,04); nutrition length area and saliva releasing (p=0.01) and consistency about dysphagia complaint (p=0.045); communication area (p=0.04) and oral phase alteration (p=0.036) as well as current nutrition and the area frequency of the symptoms and chewing alterations (p=0.038). Conclusion. It has been found that patients with Parkinson’s disease with risk of dysphagia sufferers impact on quality of life, especially in the field of oral communication.