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Standard Recommendations (standard + recommendation)
Selected AbstractsHome-based therapy for oedematous malnutrition with ready-to-use therapeutic foodACTA PAEDIATRICA, Issue 8 2006Michael A. Ciliberto Abstract Background: Standard recommendations are that children with oedematous malnutrition receive inpatient therapy with a graduated feeding regimen. Aim: To investigate exclusive home-based therapy for children with oedematous malnutrition. Methods: Children with oedematous malnutrition, good appetite and no complications were treated at home with ready-to-use therapeutic food (RUTF) and followed up fortnightly for up to 8 wk. Setting and participants: 219 children aged 1,5 y with oedema enrolled in one of two therapeutic nutritional studies in Malawi in 2003,2004. Results: The overall recovery rate was 83% (182/219), and the case-fatality rate was 5% (11/219). For children with wasting and oedematous malnutrition, 65% (55/85) recovered and 7% (6/85) died. The average weight gain was 2.8±3.2 g/kg/d (mean±SD). Conclusion: This preliminary observation suggests that children with oedematous malnutrition and good appetite may be successfully treated with home-based therapy; a randomized, controlled trial to evaluate this is warranted. [source] Impact of some isoenergetic snacks on satiety and next meal intake in healthy adultsJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 5 2009E. Almiron-Roig Abstract Background:, Choosing small portions especially of low energy foods is a standard recommendation for weight management. However, this can result in rapid return of hunger or an increase in the next meal size. Enhancing the satiating capacities of low energy foods may help to overcome these effects. The present study compared the satiating properties of small servings of four low energy foods [465 kJ (111 kcal)] including a drinking yogurt enhanced for satiety. Methods:, Thirty volunteers attended the laboratory to consume isoenergetic preloads of: a fibre-enriched drinking yogurt, a regular drinking yogurt, plain crackers, fresh banana; or an isovolumetric serving of water. Satiety was analysed using visual analogue scales, before and every 15 min after consumption for 60 min, when ad libitum food intake was measured. Results:, The yogurts and the banana were more satiating than water and crackers (P < 0.001 for yogurts and banana versus crackers and water). Only the fibre-enriched yogurt produced higher satiety scores than crackers at 60 min (P < 0.05). Mean ± SD consumption at next meal was: fibre-enriched yogurt 2050 ± 787 kJ (490 ± 188 kcal); regular yogurt 2071 ± 575 kJ (495 ± 137 kcal); bananas 2178 ± 603 kJ (520 ± 144 kcal); crackers 2232 ± 590 kJ (533 ± 141 kcal); water 2519 ± 741 kJ (602 ± 177 kcal); (yogurts versus water: P = 0.001; bananas versus water: P = 0.013; crackers versus water: P = 0.064), demonstrating accurate energy compensation for the yogurts only. Conclusions:, Although there were no significant differences between the different foods' satiating capacity, a trend for the following ranking was found: fibre-enriched yogurt > regular yogurt > banana > crackers > water. Overall, the fibre-enriched drinking yogurt tended to be more satiating than the other foods. [source] Does food allergy cause atopic dermatitis?DERMATOLOGIC THERAPY, Issue 2 2006Food challenge testing to dissociate eczematous from immediate reactions ABSTRACT:, The objective is to evaluate and diagnose, in a controlled setting, suspected food allergy causation in patients hospitalized for management of severe, unremitting atopic dermatitis (AD). Nineteen children were hospitalized at Oregon Health and Science University with atopic dermatitis from 1986 to 2003 for food restriction, then challenge, following standard recommendations. Challenges were prioritized by categories of (a) critical foods (e.g., milk, wheat, egg, soy); (b) important foods; and (c) other suspected foods. Patients were closely observed for evidence of pruritus, eczematous responses, or IgE-mediated reactions. If results were inconsistent, double-blind, placebo-controlled food challenge was performed. A total of 17 children with atopic dermatitis were assessed. Two could not be fully evaluated, thus were excluded from data tabulations. Only one positive eczematous food response was observed of 58 challenges. Three children had well-documented histories of food-induced IgE-mediated anaphylactoid or urticaria reactions to seafood and/or nuts and were not challenged with those foods. Atopic dermatitis, even in the highest-risk patients, is rarely induced by foods. Undocumented assumptions of food causation detract from proper anti-inflammatory management and should be discouraged. Immediate IgE-mediated food reactions are common in atopic dermatitis patients; such reactions are rapid onset, typically detected outside the clinic, and must be distinguished from eczematous reactions. Diagnosis of food-induced eczema cannot be made without food challenge testing. Such tests can be practical and useful for dispelling unrealistic assumptions about food allergy causation of atopic dermatitis. [source] Echocardiographic evaluation of patients cured of childhood cancer: A single center study of 117 subjects who received anthracyclinesPEDIATRIC BLOOD & CANCER, Issue 6 2001Grazia Bossi MD Abstract Background The risk of cardiomyopathy following exposure to anthracycline in asymptomatic long-term survivors of childhood cancer is still hard to predict and precisely quantify. To identify the impact of different cumulative doses, even within a non-high dose range, and the echocardiographic parameters suitable for evaluating cardiac function, we studied diastolic and systolic echocardiographic parameters in a cohort of patients followed in a single center. Procedure A total of 117 subjects were studied at a median time of 7 years after treatment completion. A complete M-mode, two-dimensional and Doppler echocardiographic study was obtained at rest in all patients according to the standard recommendations of the American Society of Echocardiography. Results Ninety-nine patients (85%) had completely normal cardiac function, while 18 had abnormal echocardiographic findings: 12 had one abnormal value, 5 had two, and 1 had three abnormal values. All the changes were in left ventricular dimensions, wall thickness or indices of systolic function; no alterations in left ventricular diastolic function parameters were found. None of the echocardiographic parameters correlated significantly with the cumulative dose of anthracyclines administered either at univariate analysis or after adjusting for sex, body surface area or considered risk factors. Conclusions Subjects exposed to a median cumulative dose of 214,mg/m2 had no echographic abnormalities a median of 7 years later. We did not find any correlation between cumulative anthracycline dose and the echocardiographic parameters tested. We now offer echocardiographic follow-up to patients with mildly reduced fractional shortening and/or ejection fraction to rule out late onset dysfunction. Med. Pediatr. Oncol. 36:593,600, 2001. © 2001 Wiley-Liss, Inc. [source] Intrinsische Motivation und umweltpolitische InstrumentePERSPEKTIVEN DER WIRTSCHAFTSPOLITIK, Issue 2 2001Erik Gawel In the discussion on the rational choice model of individual behavior, a growing emphasis has recently been placed on the importance of intrinsic motivation. Contrary to assumptions made in the standard economic literature, it is suggested that an individual's motivation to act may not be exclusively determined by external influences (incentives, restrictions) and (given) personal preferences, but, in addition, depends on intrinsically anchored ethical preferences. Intrinsic motivation may diminish if parallel external incentives, such as rewards or orders, come into play: Insofar as external intervention weakens the corresponding intrinsic motivation to act, the (normal) effect of relative prices is opposed by a (countervailing) crowding-out effect of intrinsic motivation. The effect of (over-) crowding-out has been thematized especially in the context of environmental policy. It was suggested that subsidies may support intrinsic incentives whereas taxes and licences (especially though command-and-control measures) tend to undermine them. This paper critically analyzes the impact of intrinsic behavior considerations on the evaluation of environmental policy instruments. It is argued that, if at all, economists' standard recommendations for policy design with respect to subsidies need not be revised even if intrinsic motivation plays any role for the agents' environmental bevavior. Furthermore, command-and-control policy might rather support than weaken intrinsic motivation. [source] Compliance with Recommended Cancer Screening among Emergency Department Patients: A Multicenter SurveyACADEMIC EMERGENCY MEDICINE, Issue 5 2008Adit A. Ginde MD Abstract Objectives:, The objectives were to measure compliance with, and possible sociodemographic disparities for, cancer screening among emergency department (ED) patients. Methods:, This was a cross-sectional survey in three academic EDs in Boston. The authors enrolled consecutive adult patients during two 24-hour periods at each site. Self-reported compliance with standard recommendations for cervical, breast, testicular, and prostate cancer screening were measured. The chi-square test was used test to evaluate associations between demographic variables and cancer screening compliance. Results:, The authors enrolled 387 patients (81% of those eligible). The participants had a mean (±standard deviation) age of 44 (±18) years and were 52% female, 16% Hispanic, and 65% white. Sixty-seven percent (95% confidence interval [CI] = 60% to 73%) of all women reported Pap smear examinations in the past 3 years, 92% (95% CI = 85% to 96%) of women aged ,40 years reported clinical breast examinations, and 88% (95% CI = 81% to 94%) of women aged ,40 years reported mammography. Fifty-one percent (95% CI = 40% to 61%) of men aged 18,39 years reported testicular self-examinations, and among men aged ,40 years, 79% (95% CI = 69% to 87%) reported digital rectal examinations (DREs) and 51% (95% CI = 40% to 61%) reported prostate-specific antigen (PSA) testing. Racial and ethnic minorities reported slightly lower rates of clinical breast examinations and testicular self-examinations. Conclusions:, Most women and a majority of men in our ED-based study were compliant with recommended measures of cervical, breast, testicular, and prostate cancer screening. No large sociodemographic disparities in our patient population were identified. Based on these data, and the many other pressing public health needs of our ED population, the authors would be reluctant to promote ED-based cancer screening initiatives at this time. [source] | ||||||||||