Nutritional status and its influencing factors in children with newly diagnosed inflammatory bowel disease / 中国当代儿科杂志

OBJECTIVES@#To investigate the nutritional status and its influencing factors in children with newly diagnosed inflammatory bowel disease (IBD).@*METHODS@#A retrospective analysis was conducted on the clinical data of children who were diagnosed with IBD for the first time in Hunan Children's Hospital from January 2015 to December 2021. Diagnostic delay was defined as the time from the symptom onset to IBD diagnosis being in the upper quartile (P76-P100) of all IBD children in the study. Multivariate logistic regression analysis was used to explore the risk factors for emaciation and growth retardation.@*RESULTS@#A total of 125 children with newly diagnosed IBD were included, with Crohn's disease being the main type (91.2%). The rates of emaciation and growth retardation were 42.4% (53 cases) and 7.2% (9 cases), respectively, and the rate of anemia was 77.6% (97 cases). Diagnostic delay was noted in 31 children (24.8%), with the time from the symptom onset to IBD diagnosis of 366 to 7 211 days. Multivariate logistic regression analysis showed that diagnostic delay was a risk factor for emaciation and growth retardation (OR=2.73 and OR=4.42, respectively; P<0.05) and that age was positively associated with emaciation (OR=1.30, P<0.05).@*CONCLUSIONS@#Children with newly diagnosed IBD have poor nutritional status, and the rates of anemia, emaciation, and growth retardation are high. Diagnostic delay is associated with malnutrition in children with IBD.

Fluorosis. Antivet contra ácido clorhídrico / fluoride. Antivet vs hydrochloric acid

Introducción: La fluorosis dental es una hipomineralización del esmalte producida como respuesta a la ingesta de fluor por un periodo prolongado durante la formación del esmaltado. Es una alteración irreversible, que clínicamente se caracteriza por la presencia de delgadas líneas blanquecinas distribuidas en el esmalte dental correspondientes a la disposición de las periquimatías, y en grados más avanzados de la enfermedad se odservan cambios en toda la superficie del esmaltado que adquiere un aspecto opaco, como de piedra caliza. En los niveles más severos de flurosis dental, la presencia de hipomineralización, y el aumento en la porosidad del esmalte dental propicia la pérdida de porciones importantes de su estructura, produciendo fracturas, por lo que se deteriora la apariencia y funcionalidad de los dientes afectados. (1) La OMS recomienda que el valor de referencia para el fluoruro en el agua potable es de 1,5 mg /1.(2) El flúor es un gas halógeno, el más electronegativo de los elementos de la tabla periódica, con número atómico 19, prácticamente no existe libre en la naturaleza, sino asociado a otros elementos como: calcio y sodio. La principal vía de incorporación del flúor en el organismo humano es la digestiva. Es absorbido rápidamente en la mucosa del intestino delgado y del estómago, por un simple fenómeno de difusión. Una en los tejidos, depositándose preferentemente en los tejidos duros; se elimina por todas las vías de excreción, principalmente por orina. La cantidad de flúor en el organismo es variable y depende de la ingestión, inhalación, absorción y eliminación, así como de las características de los compuestos. Generalmente se concentra en huesos, cartílagos, dientes y placa bacteriana. El depósito de flúor varía con la edad y la excreción. En los niños, el 50% se fija en huesos y dientes en formación; en adultos, se deposita básicamente en huesos. (3) Existen diversos métodos para su eliminación. En esta investigación se realizaron 18 procedimientos a pacientes de ambos sexos. La metodología fue dividir en dos grupos de 8 personas cada uno, en el cual se utilizó Antivet en el primer grupo y ácido clorhídrico al 18% en el segundo grupo. Los casos fueron seleccionados al azar y posteriormente se observaron los cambios clínicos con cada grupo. En el primer grupo de personas que utilizaron Antivet, se mostró que en casos severos de fluorosis no era un método tan eficaz, ya que no elimina por completo las manchas marrones, sin embargo, es un procedimiento muy bueno para uso clínico cuando los grados de fluorosis son menores. En el segundo grupo de personas que utilizaron ácido clorhídrico al 18% se demostró la eficacia del tratamiento en fluorosis de grados avanzados, donde el esmalte está más del 50% dañado, por lo que es un excelente método de tratamiento con el debido control en su manipulación. Objetivo: Saber diferenciar los tipos de materiales y conocer los diferentes métodos para eliminación de flúor así como mostrar la diferencia entre tratamientos. Metodología: El tipo de estudio es explicativo y con el cual se espera contribuir al desarrollo del conocimiento científico. Su realización supone el ánimo de contribuir al desarrollo del saber científico. Consistió en seleccionar 16 pacientes, masculinos y femenonos y de distintas edades de entre 15 y 40 años. Se dividieron al azar, en 2 grupos de 8 personas cada uno para tratarlos con 2 productos diferentes. El primer grupo fue tratado con ácido clorhídrico al 18% y el segundo grupo con la marca comercial Antivet. Resultado y conclusión: La fluorosis dental es causada por ingestas excesivas de flúor. El uso del ácido clorhídrico es corrosivo, su aroma es penetrante y los cuidados con el paciente son mayores, ya que un mal uso al tener contacto con piel o mucosa creará necrosis. El Antivet tiene desventajas de costo y disponibilidad, pero su ventaja es que brinda más seguridad en su manipulación.

Introduction: Dental fluorosis is a hypomineralization of the enamel produced due to fluoride intake for a prolonged time during enamel formation. It is an irreversible alteration, which is clinically characterized by the presence of thin whitish lines distributed in the dental enamel corresponding to the disposition of the perikymata. In more advanced degrees of the disease, changes are observed in the entire enamel surface, which acquires an opaque appearance, like limestone. In the most severe levels of dental fluorosis, the presence of hypomineralization and increased porosity of the dental enamel leads to the loss of essential portions of its structure, producing fractures, thus deteriorating the appearance and functionality of the affected teeth. (1) The WHO recommends that the reference value for fluoride in drinking water is 1.5 mg/l. (2) Fluoride is a halogen gas, the most electronegative of the periodic table elements, with atomic number 19. It practically does not exist free in nature but is associated with other elements such as calcium and sodium. The primary way of incorporating fluorine into the human organism is through the digestive system. It is rapidly absorbed in the mucosa of the small intestine and stomach by a simple phenomenon of diffusion. Once absorbed, fluoride passes into the blood and is distributed in the tissues, preferentially deposited in hard tissues; it is eliminated by all excretion routes, mainly by the urine. The amount of fluoride in the body is variable and depends on ingestion, inhalation, absorption, elimination, and the characteristics of the compounds. It is generally concentrated in bones, cartilage, teeth, and bacterial plaque. Fluoride deposition varies with age and excretion. In children, 50% is fixed in bones and teeth information; it is basically deposited in bones in adults. (3) There are various methods for its elimination. In this research, 18 procedures were performed on patients of both sexes. The methodology was divided into two groups of 8 persons each, in which Antivet was used in the first group and 18% hydrochloric acid in the second group. The cases were randomly selected, and subsequently, the clinical changes were observed in each group. In the first group of people who used Antivet, it was shown that in severe cases of fluorosis, it was not such an effective method since it does not completely eliminate the brown stains. However, it is a very effective method for clinical use when the degrees of fluorosis are lower. In the second group of people who used 18% hydrochloric acid, the effectiveness of the treatment was demonstrated in advanced degrees of fluorosis, where the enamel is more than 50% damaged, making it an excellent method of treatment with due control in its manipulation. Objective: To differentiate the types of materials and to know the different methods for fluoride elimination as well as to show the difference between treatments. Methodology: The type of study is explanatory, and it is expected to contribute to the development of scientific knowledge. It was carried out to contribute to the development of scientific knowledge. It consisted of selecting 16 patients of both sexes and of different ages between 15 and 40 years old. They were randomly divided into two groups of 8 persons, each to be treated with two different products. The first group was treated with 18% hydrochloric acid, and the second group with the comercial brand Antivet. Result and conclusion: Dental fluorosis is caused by excessive fluoride intake. Hydrochloric acid is corrosive, its aroma is penetrating, and the care with the patient is greater since a wrong use when in contact with skin or mucosa will create necrosis. Antivet has disadvantages of cost and availability, but its advantage is that it provides more safety in its handling.

A Case of Goreisan with hoketsuzai (Blood-Tonifying Formula) that was Remarkably Effective for Severe Malnutrition / 日本東洋医学雑誌

We report a case in which goreisan with hoketsuzai (blood-tonifying formula) was successful in the treatment of a marked nutritional disorder. A 17-year-old woman was screened for prominent emaciation of unknown cause. After the administration of goreisan, edema was reduced and her body weight increased. Subsequently, anemia improved and muscle mass increased with a combination of shimotsuto or sokeikakketsuto. It is possible that goreisan with hoketsuzai improved the water balance of the whole body including the digestive tract, and restored the digestive and absorptive function.

Nutritional status of students aged 6-16 years of the National Nutrition Improvement Program for Rural Compulsory Education Students in Henan Province from 2012 to 2019 / 中国学校卫生

Objective@#To understand the changes of students nutritional status in the National Nutrition Improvement Program for Rural Compulsory Education Students (NNIPRCES) of Henan Province, and to provide scientific basis for designating scientific nutritional intervention measures.@*Methods@#About 20%-30% of primary schools and middle schools in the pilot counties in Henan Province were selected to monitor the nutritional status of students. Surveillance data from 2012 to 2019 were analyzed.@*Results@#From 2012 to 2019(no surveillance data were available in 2018), the detection rates of mild thinness were 4.0%, 3.3%, 3.3%, 3.6%, 3.1%, 2.9%, 4.4%, respectively; the detection rates of moderate and severe thinness were 4.5%, 4.5%, 4.4%, 4.6%, 3.9%, 3.6%, 5.1%, respectively; the detection rates of overweight were 9.6%, 12.4%, 12.3%, 12.2%, 12.7%, 13.4%, 11.1%, respectively; and the detection rates of obesity were 3.9%, 6.8%, 6.7%, 6.2%, 7.6%, 7.2%, 5.8%, respectively. The differences were statistically significant (χ 2=1 032.29, 4 771.39, P<0.05). The detection rates of 2019 mild (5.0%, 3.7%) and moderate to severe thinness (5.9%, 4.3%) were the highest for both male and female students, and the highest for primary school students and junior middle school students were the highest for 2019 mild (4.1%, 6.0%) and moderate to severe thinness (5.1%, 4.9%), with statistical significance (χ 2=653.22, 486.46, 919.07, 306.27, P<0.05). The detection rate of overweight was the highest in both males and females (14.8%, 11.8%) in 2017, and the detection rate of obesity was the highest in 2016 (8.3%, 6.9%). The detection rates of overweight and obesity in primary school students were the highest in 2017 and 2016 (13.7%, 8.4%), and the detection rates in middle school students were the highest in 2017 (11.5%, 3.0%), with statistical significance (χ 2=2 391.65, 2 371.74, 4 827.75, 512.64, P<0.05).@*Conclusion@#In the early stage of the implementation of NNIPRCES in Henan Province, malnutrition among students has improved, however, the contem porary malnutrition shows increasing trend, and the co occurrence of malnutrition and obesity calls for targeted nutritional intervention measures.

The association between body mass index and postoperative complications in patients with colorectal cancer / 中国基层医药

Objective To investigate the association between body mass index and postoperative complications in patients with colorectal cancer.Methods 120 patients with colorectal cancer were prospectively studied.According to the body mass index,all patients were assigned to study group (BMI ＜ 18.5kg/m2) or control group (BMI ≥ 18.5kg/m2),60 cases in each group.All patients received elective colorectal cancer resection.The operation situation,postoperative complications,postoperative recovery and postoperative stress reaction of the two groups were observed.Results There were no significant differences in the operation time,the number of lymph node dissection and the amount of bleeding between the two groups during the operation (all P ＞ 0.05).Compared with the control group,the total infection rate of the study group was significantly higher(11.67％ vs.1.67％,x2 =4.324,P =0.038);the incidence of postoperative complications was significantly increased (25.00％ vs.5.00％,x2 =7.908,P =0.005).There were no significant differences in other complications such as wound infection,anastomotic leakage,anastomotic obstruction,adverse cardiovascular events and stress ulcer (all P ＞ 0.05).Compared with the control group,the postoperative anal exhaust time of the study group was significantly prolonged [(51.48 ± 9.47) h vs.(43.73 ± 8.63) h,t =5.382,P =0.000];and the length of hospital duration was significantly prolonged [(20.35 ± 3.21) d vs.(16.28 ± 3.48) d,t =6.462,P =0.000].There were no significant differences in recurrence rate,mortality rate and progression free survival between the two groups after 1 year (all P ＞ 0.05).There were no significant differences in preoperative IL-6 and CRP levels between the two groups (all P ＞ 0.05).Compared with the control group,the IL-6 level of the study group at 7-day after operation was significantly higher[(165.56 ±45.39) ng/L vs.(122.58 ± 29.58) ng/L,t =6.459,P =0.000];CRP level was significantly higher [(23.49 ± 8.48) mg/L vs.(15.37 ±6.53)mg/L,t =4.285,P=0.002].Conclusion Body mass index less than 18.5 kg/m2 is a risk factor for postoperative infection and complications in patients with colorectal cancer,and is associated with increased stress response and prolonged hospital stay.

<b>A Case of Respiratory Tract</b> <b>Infection Successfully Treated </b><b>with Low-dose Daisaikotokabosho </b> / 日本東洋医学雑誌

We report a 68 year-old woman being treated for anorexia. Despite our treatment, her body weight decreased to 22 kg and she was admitted to our hospital ER for Wernicke's encephalopathy and a hypoglycemic attack, which both occurred on January 21 st. She experienced respiratory failure and was placed on a respirator. On March 24 th she developed a fever due to a respiratory tract infection, and antibiotics and keishinieppiichito were administered.<br>On March 26 th she again developed a fever. One tenth of the normal daily dose of daisaikotokabosho was administered successfully. However, she had a fever again on March 31 st. The following day, one tenth of the normal daily dose of daiaikotokabosho was administered successfully. The formula was continued and the fever disappeared after April 3rd.<br>Whether the base formula of saikokaboshoto is daisaikoto or shosaikoto remains controversial. Our case was suspected of rinetsu, excessive pathogenic heating of the interior body, and her abdominal symptoms indicated daisaikoto. Therefore daisaikotokabosho, which is closely related to yomeibyo as a shoyobyo, was administered effectively.<br>This case suggests that a grossly underweight patient, in whom hypo function or yin condition would usually be seen, has the potential to change to hyper function or a yang condition. In such a case, dose adjustment for physical size and body energy is necessary.

Application of fist clenching method with shaking hands in venipuncture to elderly angular patients / 中国实用护理杂志

Objective To evaluate application of fist clenching method with shaking hands in venipuncture to elderly angular patients. Methods 360 elderly angular patients were randomly divided into group A and group B with 180 cases in each group. Group A used fist clenching method with shaking hands, group B adopted traditional fist clenching method in venipuncture. Pain degree and one-time success rate of two groups were compared. Results One-time success rate of group A in venipuncture was obviously higher than group B, while pain degree of group A was less than group B. Conclusions Fist clenching method with shaking hands to elderly angular patients can raise success rate in venipuncture, and reduce pain degree of patients.

Emaciated Patient with Slowly Progressed Type 1 Diabetes Mellitus who had hypoglycemia Despite Impaired Insulin Secretion / General Medicine

We describe a 38-year-old, severely emaciated female with slowly progressive type 1 diabetes mellitus (SPIDDM), who had hypoglycemia due to fasting and an extremely low energy intake. After being diagnosed with diabetes mellitus (DM), she took in only 300-500 kcal per day and her weight had decreased to 30 kg, with a body mass index (BMI) of 11.4 kg/m². She was admitted with hypoglycemia, and SPIDDM was confirmed by nearly-completely ceased insulin secretion and seropositivity towards anti-GAD antibody. After appropriate dietary therapy and insulin administration, she recovered from a state of emaciation and her glucose metabolism was restored. With this patient it proved very effective for the general physician to coordinate treatment for both diabetes and an eating disorder.