RESUMO
Protein-energy malnutrition reduces the quality of life, lengthens the time in hospital and dramatically increases mortality. Currently there is no simple and objective method available for assessing nutritional status and identifying malnutrition. The aim of this work is to develop a novel assistance system that supports the physician in the assessment of the nutritional status. Therefore, three subject groups were investigated: the first group consisted of 688 healthy subjects. Two additional groups consisted of 707 patients: 94 patients with primary diseases that are known to cause malnutrition, and 613 patients from a hospital admission screening. In all subjects bioimpedance spectroscopy measurements were performed, and the body composition was calculated. Additionally, in all patients the nutritional status was assessed by the subjective global assessment score. These data are used for the development and validation of the assistance system. The basic idea of the system is that nutritional status is reflected by body composition. Hence, features of the nutritional status, based on the body composition, are determined and compared with reference ranges, derived from healthy subjects' data. The differences are evaluated by a fuzzy logic system or a decision tree in order to identify malnourished patients. The novel assistance system allows the identification of malnourished patients, and it can be applied for screening and monitoring of the nutritional status of hospital patients.
Assuntos
Composição Corporal , Diagnóstico por Computador/métodos , Lógica Fuzzy , Desnutrição/diagnóstico , Desnutrição/fisiopatologia , Pletismografia de Impedância/métodos , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reconhecimento Automatizado de Padrão/métodos , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
This paper presents the mathematical simulation of the human circulatory system. The model is based on the former work of Coleman and co-workers and has been redesigned for simulation with the Matlab toolbox "Simulink". It includes the heart and the peripheral circulation, the respiratory system, the kidneys and the major neural and hormonal control mechanisms, which are necessary for maintaining homeostasis. The model contains more than 30 blocks with over 200 physiological variables, which can be accessed and plotted during the simulation.
