dcem1 malnutrition
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Protein-EnergyMalnutrition
Elsa xxx DCEM1
Toulouse Purpan medical school
23/03/09
lethungerend.com
www.answers.com
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Overview Definition
Localization
Kwashiorkor
Marasmus
Complications
Treatment and prevention
Initial refeeding
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Definition Form of malnutrition
(undernutrition)
Micronutrient deficiency
Children 6 months to 5 years
Result from- Lack of food
- Infections with loss ofappetite
www.msf.ch
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Localization
In many developing countries: Africa +++
www.planetthoughts.org
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Types of PEM Kwashiorkor:
- Insufficient proteinconsumption
- Child weaned: mothers milkto starchy vegetables
Marasmus
- Energy deficiency
Marasmic-Kwashiorkor
- Deficiency of both caloriesand protein
www.fao.org
www.fao.org
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Kwashiokor Weight loss:
- arms and legs
- decrease of muscle mass
Swollen abdomen
- ascites: increase of capillary
permeability- enlarged liver: fatty liver
Peripheral oedema: decrease of
oncotic pressure
Anemia: lethargy
Hair and skin changeswww.femininbeaute.com
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Marasmus
Weight loss: skin and bones
Prominent of ribs
Drastic loss of adipose tissue
Growth retardation
Chronic diarrhea
Muscle atrophy
Skin folds
old man facehunnyken.blogspot.com
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Complications of PEM Hypoglycemia
Hypothermia
Dehydration and shock
Electrolyte imbalance
- hypokalemia- hyponatremia
Infections (bacterial, viral and thrush)
Micronutrient deficiencies
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Treatment and prevention
Correction of water and
electrolyte balance
Treat infection and
worm infestations
Dietary support
- 3-4g protein and 200 cal/
kg body weight/day
- Vitamins and minerals
Prevention of hypothermia
Counsel parents andplan future includingimmunization and diet
supplements
www.doctorswithoutborders.org
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Initial refeeding Continue breast feeding
Add frequent small feeds
Use liquid diet
Give vitamin A and folic acidon admission
With diarrhea use lactose-free or soya bean formula
library.thinkquest.org
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Take home message Protein-energy malnutrition = undernutrition
+++ in developing countries
2 types of PEM
- Kwashiorkor: protein deficiency + oedema- Marasmus: calories deficiency
Interaction PEM / infection major cause of death
Treatment:
- progressive refeeding
- treatment of infections
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Bibliography http://www.pitt.edu/~super1/lecture/lec17671/047.htm
http://findarticles.com/p/articles/mi_g2601/is_0011/ai_2601001129/pg_2?tag=content;col1
http://www.emro.who.int/nutrition/pdf/protein_malnutrition.pdf
http://www.merck.com/mmpe/sec01/ch002/ch002b.html http://en.wikipedia.org/wiki/Marasmus
http://en.wikipedia.org/wiki/Kwashiorkor
http://lib.bioinfo.pl/meid:128260 http://www.healthatoz.com
http://www.hpathy.com/diseases/marasmus.asp