Mechanisms of Malnutrition in Cirrhosis With Portosystemic Shunting
CirrhosisCirrhosis is characterized by loss of muscle as well as fat mass, which increases morbidity and mortality before, during, and after liver transplantation. A common mechanism for the reduced muscle and fat mass in cirrhosis is an increased expression of the TGF (transforming growth factor)beta superfamily member, myostatin, in the muscle and adipose tissue. The present study will examine the expression of myostatin, its receptor and intracellular signaling pathways in the skeletal muscle and mesenteric adipose tissue in cirrhotic patients undergoing liver transplantation as compared to healthy controls undergoing planned abdominal surgery. 16 cirrhotic patients will be identified from the transplant list, and 16 healthy controls from outpatient surgery lists. Nutritional assessment will be performed, including anthropometry (triceps skinfold thickness, mid arm circumference), dual energy x-ray absorptiometry (DEXA), and bioelectrical impedance analysis (BIA). Rectus abdominis muscle tissue and omental fat tissue will be harvested in the operating room, and the expression of signaling proteins involved in skeletal muscle protein synthesis will be quantified. The investigator will also quantify the expression of genes involved in lipolysis and lipid synthesis. The investigator anticipates that the expression of myostatin will be higher in the skeletal muscle and adipose tissue of cirrhotics as compared to controls. There will be a reduction in the expression of the signaling proteins that regulate skeletal muscle protein synthesis, as well as the expression of genes regulating lipogenesis. The increased expression of myostatin will also correlate with reduced anthropometric and DEXA measurements of lean body mass and fat mass.
The Impact of Malnutrition on Immune Responses to Tuberculosis
MalnutritionChild1 moreThe aim of this study is to assess immune responses to Mtb in children with MAM compared to well-nourished children and to evaluate the impact of a nutrition intervention on these immune responses.
Indirect Calorimetry in Patients at Risk of Malnutrition
BurnsCritical Illness3 moreBurn patients treated in an outpatient clinic and ICU survivors are at risk of malnutrition. There are no clear guidelines determining the energy target in those two populations. The aim of this observation study is to measure the resting energy expenditure of those patients, using indirect calorimetry.
Child Health, Nutrition and Gut Microbiome Development
MalnutritionStunting3 moreChildhood malnutrition is a global public health issue with devastating consequences on the health, well-being, and psychosocial development of children. Emerging evidence suggests that malnourished children have immature gut microbiota compared to age-matched healthy controls and it does not repair even after nutritional interventions. The present study aims to characterize how the gut microbiome develops during the first two years of life in children residing in Newly Merged Districts of Khyber Pakhtunkhwa, the region with the highest prevalence of childhood malnutrition in Pakistan and the region.
Prognostic Value of Different Nutritional Screening Tools in Acute Pancreatitis
Acute PancreatitisMalnutritionThe goal of this observational study is to compare the prognostic value of different nutritional screening tools to predict the course of acute pancreatitis. The main questions it aims to answer are: Which nutritional screening tool performs best to predict length of hospital stay? Which nutritional screening tool performs best to predict clinical outcome (disease severity, length of hospital stay, mortality, need for rehospitalization)? Participants will answer questions regarding their nutritional status and undergo basic anthropometric assessments (e.g. measurement of waist circumference) to evaluate their risk of malnutrition.
The "Self Evaluation of Food Intake" (SEFI) as a Screening Test for Hospital Malnutrition in Children...
MalnutritionChildThe goal is to find a simple tool that can be used by medical and paramedical staff and that is reliable to identify children at risk for malnutrition.
123 nutritionDay in Worldwide ICUs: An International Audit and Registry on Nutrition and Outcome....
MalnutritionThe aim of this project is to increase knowledge and awareness about nutrition of ICU patients among the staff by evaluating nutrition care on an international level. In order to be able to facilitate bench-marking of ICU's with a national and international standard and actual best practice, we intend to provide a multi-lingual data acquisition tool to determine actual nutrition care in an ICU's. nutritionDay in Worldwide ICUs is a one day international cross-sectional audit.
Analyses of Malnutrition Screening in Internal Medicine
MalnutritionThe goal of this observational study is to study the presence and consequences of malnutrition risk in hospitalized internal medicine patients. The main questions it aims to answer are: How many patients are at risk of malnutrition at admission? Is there a link between an existing malnutrition risk and nutrition therapy that the patients receive? Is there a link between an existing malnutrition risk and clinical outcome (e.g. length of hospital stay, mortality, need for rehospitalization)? Participants will be screened for malnutrition risk at admission using a validated questionnaire (Nutritional Risk Screening 2002). All relevant data regarding hospital stay will be obtained from the clinical information system after discharge.
Radiomics-based Malnutrition for Cervical Cancer.
Cervical CancerMalnutritionLoss of skeletal muscle, is one of the most prevalent symptoms of malnutrition, and has been frequently reported as a negative factor in cancer patients at any disease stage. In this study, we are planning to firstly analyze the radiomics features of psoas extracted at the level of the third lumbar vertebra (L3) and then, develop a CT-based radiomics nomogram prediction model for predicting malnutrition based on their Patient-Generated Subjective Global Assessment (PG-SGA) scores in patients with International Federation of Gynecology and Obstetrics (FIGO, 2014 version) stage IB1-IIA2 cervical cancer (CC) who received postoperative radiotherapy/chemoradiotherapy (RT/CRT).
Sanitary Napkins for Urinary Assessment of Micronutrients
Focus: Nutritional DeficiencyThis study aims to find an easy urinary collection method for the assessment of urinary markers of micronutrient status.