2,992
回編集
差分
ナビゲーションに移動
検索に移動
ページの作成:「==programs== *food programs **general food distribution **selective food distribution *nutritional programs **therapeutic feeding for SAM **supplementary feeding for MAM…」
==programs==
*food programs
**general food distribution
**selective food distribution
*nutritional programs
**therapeutic feeding for SAM
**supplementary feeding for MAM
***targeted supplementary feeding programs - more curative
***blanket supplementary feeding - more preventive
==partners==
*WFP
*UNHCR
==viscious cycle==
#malnutrition
#lowered resistance, immunity
#infection
#poor appetite, decreased ingestion
#high energy utilization
#circle back to 1
==diagnosis==
===Dx of acute malnutrition===
*weight for height (W/H)
**low means wasting - acute malnutrition
*height for age (H/A)
**low means stunting - chronic malnutrition
*W/A
**low means complexity of acute and chronic - wasting and stunting "WaSt"
**WaSt correlates with mortality
*BMI (W/H<sup>2</sup>)
*MUAC
**<115mm severe acute malnutrition (SAM)
**115-125mm moderate acute malnutrition (MAM)
**MUAC strongly correlates with mortality
===reference standard of anthropometry===
*National Center for Health S (NCHS) - older
*WHO Growth Standards 2006 - newer
*Z-score <math>=\frac{actual\ value - reference\ median\ value}{standard\ deviation\ of\ reference\ population}</math>
==types of malnutrition==
*acute m.
**Marasmus
***muscle atrophy
***MUAC <115mm
**Kwashiorkor
***bilateral pitting edema
***moon face
***higher death risk than malasmus
*chronic m./stunting
**low H/A
*[[Micronutrition|micronutrient deficiency]]
*severe acute malnutrition SAM
*moderate acute malnutrition MAM
*global acute malnutrition GAM - SAM+MAM
*WHO sets interventional threshold at GAM in 15% of population
===marasmus (waste)===
*45.4 mil. children estimated in wasting in 2021
**25.0 mil. in Asia
*"old man faces"
===kwashiorkor===
*West Africa and hos spot in Zimbabwe in 2016
*bilateral pitting edema
**press for 3 seconds
**grade 1 localized to feet, grade 2 extends to lower legs, grade 3 systemic (check forehead)
*apathetic, irritable
*pathogenesis is still controversial and indefinite
*often misdiagnosed
===marasmus and kwashiorkor===
*marasmic kwashiorkor may exist
*clinical intervention is same for both condition
*effort to distinguish is useful for epidemiology and investigation of pathogenesis of kwashiorkor
==pathological change==
*heart smaller weaker
*brain smaller
==treatment==
*dietary
**therapeutic milk
**ready to use therapeutic food (RUTF)
*systematic - for complications
**antibiotics, HIV screening, etc.
*community-based management of acute malnutrition - CMAM
===phases===
#stabilization phase
#rehabilitation phase
==forecasting emergency==
*sentinel surveillance
*global early warning systems
**[https://fews.net/ Famine Early Warning Systems Network]
*country-specific warning systems
*
==definitions==
*macronutrients
**carbohydrates
**protein
**fats
*micronutrients
**vitamins
***water soluble - not stored in body
***fat soluble - stored in body
*minerals
*combination of most staple foods provide sufficient protein
===classification based on pathogenicity by deficiency===
*type 1
**deficiency causes direct symptoms but no effect on growth
*type 2
**deficiency causes failure to growth but no direct symptoms
==thiamine (vit.B1)==
*Wernicke-Korsakoff syndrome in alcoholics
===beriberi or thiamine deficiency disorder (TDD)===
*polished rice diets
*peripheral neuropathy
*wet beriberi
*adult beriberi is decreasing
*infantile beriberi
**continuous crying
**pitting edema
untreated HIV increases vit.B group deficiency
==riboflavin (vit.B2)==
*no clear deficiency disorder
==niacin (vit.B3)==
===pellagra===
*maize (corn) based diets
*symptoms
**3Ds
***dermatitis
****photosensitivity/solar dermatitis
***diarrhea
***depression/dementia
**insomnia, lethergy
*maize (corn) contains less bioavailable niacin and tryptophan that is precursor of niacin
==pyridoxine (vit.B6)==
*no clear deficiency disorder
==cobalamin (vit.B12)==
*megaloblastic anemia
==folic acid==
*megaloblastic anemia
==vitamin A==
*eye involvement
**xerophthalmia
*scurvy
*subclinical vit.A deficiency is associated with decreased immunity and increased risk of infection of and/or death by measles
==zinc==
*zinc supplementation increase survival of diarrheal patients
==iodine==
==Konzo==
*diet with poorly processed bitter cassava
*high intake of cyanogenic glucosides from cassava
*acute myeloneuropathy
==lathyrism==
*grass pea, chickling pea, kesari dal, almorta
*''Lathyrus'' spp., ''L. sativus''
*Ethiopia, Bangladesh, India, Nepal
*scissoring gait - gluteal muscle atrophy
*food programs
**general food distribution
**selective food distribution
*nutritional programs
**therapeutic feeding for SAM
**supplementary feeding for MAM
***targeted supplementary feeding programs - more curative
***blanket supplementary feeding - more preventive
==partners==
*WFP
*UNHCR
==viscious cycle==
#malnutrition
#lowered resistance, immunity
#infection
#poor appetite, decreased ingestion
#high energy utilization
#circle back to 1
==diagnosis==
===Dx of acute malnutrition===
*weight for height (W/H)
**low means wasting - acute malnutrition
*height for age (H/A)
**low means stunting - chronic malnutrition
*W/A
**low means complexity of acute and chronic - wasting and stunting "WaSt"
**WaSt correlates with mortality
*BMI (W/H<sup>2</sup>)
*MUAC
**<115mm severe acute malnutrition (SAM)
**115-125mm moderate acute malnutrition (MAM)
**MUAC strongly correlates with mortality
===reference standard of anthropometry===
*National Center for Health S (NCHS) - older
*WHO Growth Standards 2006 - newer
*Z-score <math>=\frac{actual\ value - reference\ median\ value}{standard\ deviation\ of\ reference\ population}</math>
==types of malnutrition==
*acute m.
**Marasmus
***muscle atrophy
***MUAC <115mm
**Kwashiorkor
***bilateral pitting edema
***moon face
***higher death risk than malasmus
*chronic m./stunting
**low H/A
*[[Micronutrition|micronutrient deficiency]]
*severe acute malnutrition SAM
*moderate acute malnutrition MAM
*global acute malnutrition GAM - SAM+MAM
*WHO sets interventional threshold at GAM in 15% of population
===marasmus (waste)===
*45.4 mil. children estimated in wasting in 2021
**25.0 mil. in Asia
*"old man faces"
===kwashiorkor===
*West Africa and hos spot in Zimbabwe in 2016
*bilateral pitting edema
**press for 3 seconds
**grade 1 localized to feet, grade 2 extends to lower legs, grade 3 systemic (check forehead)
*apathetic, irritable
*pathogenesis is still controversial and indefinite
*often misdiagnosed
===marasmus and kwashiorkor===
*marasmic kwashiorkor may exist
*clinical intervention is same for both condition
*effort to distinguish is useful for epidemiology and investigation of pathogenesis of kwashiorkor
==pathological change==
*heart smaller weaker
*brain smaller
==treatment==
*dietary
**therapeutic milk
**ready to use therapeutic food (RUTF)
*systematic - for complications
**antibiotics, HIV screening, etc.
*community-based management of acute malnutrition - CMAM
===phases===
#stabilization phase
#rehabilitation phase
==forecasting emergency==
*sentinel surveillance
*global early warning systems
**[https://fews.net/ Famine Early Warning Systems Network]
*country-specific warning systems
*
==definitions==
*macronutrients
**carbohydrates
**protein
**fats
*micronutrients
**vitamins
***water soluble - not stored in body
***fat soluble - stored in body
*minerals
*combination of most staple foods provide sufficient protein
===classification based on pathogenicity by deficiency===
*type 1
**deficiency causes direct symptoms but no effect on growth
*type 2
**deficiency causes failure to growth but no direct symptoms
==thiamine (vit.B1)==
*Wernicke-Korsakoff syndrome in alcoholics
===beriberi or thiamine deficiency disorder (TDD)===
*polished rice diets
*peripheral neuropathy
*wet beriberi
*adult beriberi is decreasing
*infantile beriberi
**continuous crying
**pitting edema
untreated HIV increases vit.B group deficiency
==riboflavin (vit.B2)==
*no clear deficiency disorder
==niacin (vit.B3)==
===pellagra===
*maize (corn) based diets
*symptoms
**3Ds
***dermatitis
****photosensitivity/solar dermatitis
***diarrhea
***depression/dementia
**insomnia, lethergy
*maize (corn) contains less bioavailable niacin and tryptophan that is precursor of niacin
==pyridoxine (vit.B6)==
*no clear deficiency disorder
==cobalamin (vit.B12)==
*megaloblastic anemia
==folic acid==
*megaloblastic anemia
==vitamin A==
*eye involvement
**xerophthalmia
*scurvy
*subclinical vit.A deficiency is associated with decreased immunity and increased risk of infection of and/or death by measles
==zinc==
*zinc supplementation increase survival of diarrheal patients
==iodine==
==Konzo==
*diet with poorly processed bitter cassava
*high intake of cyanogenic glucosides from cassava
*acute myeloneuropathy
==lathyrism==
*grass pea, chickling pea, kesari dal, almorta
*''Lathyrus'' spp., ''L. sativus''
*Ethiopia, Bangladesh, India, Nepal
*scissoring gait - gluteal muscle atrophy
