Sarcopenia and consumptive syndrome in HIV-infected patients receiving antiretroviral therapy in a public hospital in Northeast Brazil / Sarcopenia y síndrome de emaciación en pacientes infectados por el HIV que reciben terapia antiretroviral en un hospital público en el noreste Brasil

We evaluated the prevalence of sarcopenia and wasting syndrome, as well as the associated factors in HIV-infected patients receiving antiretroviral therapy. We utilized a cross-sectional study evaluating HIV-infected individuals at a university hospital in the Northeast area of Brazil. In 99 patients, sarcopenia was assessed by analysis of muscle mass, muscle strength and physical performance. Wasting syndrome was assessed by unintentional weight loss criteria. Demographic, socioeconomic, anthropometric, as well as clinical and lifestyle variables were also evaluated. The prevalence of sarcopenia in this sample was 18.2% and 33.3% presented severe sarcopenia. Wasting syndrome was identified in 13.1% and 4% presented both conditions. Sarcopenia had higher prevalence in older patients (80.0 vs 4.9%, p= 0.004), among those with diabetes mellitus (50.0 vs 16.1%, p= 0.037), as well as among malnourished individuals (p= 0.003). Wasting syndrome was more prevalent in individuals with a lower level of education (26.3%vs5.4%, p= 0.005), in the lower income tertile (p= 0.041), and a lower CD4+ T cell count (429±450 vs 654±321 cells/mm3, p= 0.045). Sarcopenia and wasting syndrome are still clinical problems present in those using antiretroviral therapy associated with specific conditions in HIV patients.

Se evaluó la prevalencia de la sarcopenia, síndrome de emanciación y factores asociados en pacientes infectados por HIV que recibieron terapia antirretroviral. En la evaluación de las personas infectadas por el HIV se aplicó un diseño de tipo transversal y fue realizado en un hospital universitario en la zona noreste del Brasil. La sarcopenia se evaluó mediante la medición de la masa muscular, la fuerza muscular y el rendimiento físico. El síndrome de emanciación se evaluó mediante criterios de pérdida de peso involuntarios. También se evaluaron las características demográficas, socioeconómicas, antropométricas, así como las variables clínicas y de estilo de vida. La prevalencia de sarcopenia en esta muestra de pacientes fue del 18,2%, y de esta población un tercio presentó sarcopenia grave. El síndrome de emanciación se identificó en el 13,1% de los pacientes y en el 4% de los sujetos que presentaron ambas condiciones. La sarcopenia tenía mayor prevalencia en pacientes de mayor edad (80,0 vs 4,9%, p= 0,004), en las personas con diabetes mellitus (50,0 vs 16,1%, p= 0,037), así como en sujetos desnutridos (p= 0,003). El síndrome de emanciación fue más prevalente en sujetos con un nivel más bajo de educación (26,3% vs 5,4%, p= 0,005), menor tercil de ingresos (p= 0,041), y menor recuento de células TCD4+ (429±450 vs 654±321 células/mm3, p= 0,045). Sarcopenia y síndrome de emanciación son todavía problemas clínicos presentes en aquellos que utilizan la terapia antirretroviral asociada con condiciones específicas en pacientes con HIV.

relationship of ethnicity, socio-economic factors and malnutrition in primary school children in north of Iran: a cross-sectional study

The main objective of this study was to assess the malnutrition and some socio-economic related factors based on three ethnic groups among primary school children in north of Iran in 2010. This cross-sectional study was carried out through multistage cluster random sampling on 5698 subjects [2505 Fars-native, 2154 Turkman, and 1039 Sistani] in 112 schools. Well-trained staffs completed the questionnaire and measured students' weight and height. Malnutrition estimated the Z-score less than -2SD for underweight, stunting and wasting were calculated using the cutoffs from WHO references. Generally, malnutrition was observed in 3.20%, 4.93% and 5.13% based on underweight, stunting and wasting respectively. It was more common in girls than in boys and in Sistani than in other ethnic groups. The correlation between malnutrition based on underweight and stunting and ethnicity was statistically significant [P=0.001]. Results of logistic regression analyses showed that the risk of malnutrition was in rural area 1.34 times more than urban area, in girls 1.17 times more than boys, in Sistani ethnic group 1.82 times more than Fars-native ethnic group, in low economic families 2.01 times more than high economic families. Underweight, stunting and wasting are the health problems in primary school children in north of Iran with a higher prevalence in girls, in rural areas, and in Sistani ethnic group

An epidemiological study of health and nutritional status of under five children in semi-urban community of Gujarat.

In developing countries, children of 0-5 years of age form a large as well as "high risk" group. Malnutrition poses a grave risk to the health of these children. The main objectives of this study were to assess the health & nutritional status of children of 0-5 years of age group & to study the influence of various epidemiological factors on health & nutritional status of children on 0-5 years of age group. It is a community based cross sectional study done in randomly selected three wards of Petlad town, district Anand in Gujarat state. 300 children of age group 0-5 years selected by systematic sampling method. Mother of each child included in the study was subjected to personal interview in her own house followed by clinical examination & anthropometric measurements of the child. The three indices of nutritional status namely, weight for age, height for age, & weight for height were expressed in standard deviation units from the median for the international reference populations as per WHONCHS standards & were compared with WHONCHS growth reference data. The prevalence of under weight (wt. for age below 2SD) was 43.67%. 50.3% children were found stunted (ht. 1br age below -2 SID) with higher prevalence in 2nd and 5th year of life. Prevalence of wasting (wt. for ht. below 2SD) was comparatively low (23.2% with a peak in 3rd year of life). These nutritional parameters showed a significant association with parental education, socio-economic status, family size, environmental conditions (safe drink water, sanitary waste disposal & overcrowding), & episodes of common diseases.

Surto de Circovirose (Síndrome Definhante Multissistêmica de Suínos Desmamados) no estado do Rio de Janeiro / Outbreak of Circovirosis (Porcine Postweaning Multisystemic Wasting Syndrome) in the state of Rio de Janeiro, Brazil

Descreve-se o primeiro surto de Síndrome Definhante Multissistêmica de Suínos Desmamados (SDMSD) na Região Sudeste do Brasil, no estado do Rio de Janeiro. A enfermidade que afetou principalmente suínos desmamados com idade em torno de 4 meses, levou a morte pelo menos 14 animais. A granja onde o surto ocorreu, tinha péssimas condições sanitárias e de manejo. Clinicamente, a doença caracterizou-se por má condição corporal, pouco desenvolvimento, tosse, taquipnéia, dispnéia, diarréia, ataxia, tremores após estímulo, decúbito e convulsões, com evolução aguda a subaguda. A necropsia, os achados mais importantes foram um aumento de volume de linfonodos e pulmões não-colapsados, com áreas consolidadas, principalmente nos lobos craniais e porção anterior dos lobos médios. O exame histológico revelou, com maior freqüência, infiltração linfo-histiocítica com células sinciciais em linfonodos, baço, placas de Peyer, rim, pulmão e fígado, depleção ou hiperplasia linfóide, bem como pneumonia bronco-intersticial linfo-histiocitária e áreas de broncopneumonia secundária. O diagnóstico firmou-se pela observação dos sintomas e das lesões histológicas típicas e foi confirmado por exame imunohistoquímico e PCR. O estudo teve por objetivo caracterizar os aspectos epidemiológico e clínico-patológico desse surto, já que a mesma tem causado grandes perdas econômicas, diretas ou indiretas, à suinocultura mundial.

Hallazgos patológicos en cerdos afectados con el síndrome del desmedro multisistémico postdestete de la República Argentina / Pathological findings in pigs affected by the postweaning multisystemic wasting syndrome in Argentina

El síndrome del desmedro multisistémico postdestete (PMWS) fue descrito por primera vez en Canadá en el año 1991 y desde entonces un número creciente de casos han sido diagnosticados en todo el mundo. En la Argentina, el PMWS fue reportado por primera vez recientemente. Se estudiaron 48 cerdos de 5 a 12 semanas de edad con signos característicos de PMWS procedentes de 19 granjas. Si bien se desconoce la distribución real del virus en nuestro país se observó desde el año 2001 un número creciente de granjas con PMWS y distribuidas en las principales provincias productoras. La histopatología fue una herramienta diagnóstica importante en casos sospechosos de PMWS con la observación de diferentes grados de lesión. En los animales estudiados las infecciones secundarias pudieron ser importantes, ya sea por patógenos oportunistas o por complicaciones bacterianas.

Postweaning multisystemic wasting syndrome was first described in Canada in 1991 and at present an increasing number of cases has been diagnosed worldwide. In Argentina the first cases of PMWS were reported recently. Forty eight 5 to 12 week old pigs with signs characteristic of PMWS from 19 farms were studied. Although the real distribution of the virus in our country is not known it was observed an increasing number of farms with PMWS distributed in the major producing provinces. The histopathology was an important tool in diagnosis of suspicious cases of PMWS with the observation of different degrees of lesion. In the studied animals, the secondary infections, either by opportunistic pathogens or secondary bacteria could be important.

Prevalence of malnutrition in rural Karnataka, South India: a comparison of anthropometric indicators.

Malnutrition is a problem at varying proportions in developing countries, and anthropometry is a simple tool to assess its magnitude in children. This study was aimed at identifying the prevalence of malnutrition among 256 children of rural areas of Karnataka in South India, who attended the aanganwadis. The value of using various field-based formulae and of various anthropometric indicators used for classification of malnutrition was also studied. The children, aged 12-60 months, came from villages located at the outskirts of Bangalore city. The prevalence of wasting, stunting, and wasting and stunting was 31.2%, 9.4%, and 29.2% respectively. Wasting was more predominant among the younger age groups (p<0.01). To detect wasting (acute malnutrition), the best indicator was a comparison with the reference weight calculated using Weech's formula. However, the age of child had to be rounded off to the nearest quarter of a year. Results of the study showed that indicators, such as mid-upper arm circumference (MUAC), needed to be used with caution since they are not sensitive enough to detect all cases of malnutrition. However, the MUAC-for-height (quac stick) method could be used since it was more sensitive. For detection of stunting, if reference tables are not available, Weech's formula can be used for calculation of expected height taking care to account for age to the nearest quarter, although the sensitivity of this indicator is not very high.