Protein-calorie malnutrition and cutaneous anergy in hemodialysis maintained patients

In 52 unselected patients maintained in intermittent hemodialysis, protein calorie malnutrition was present in 10 patients (19%). Complete cutaneous anergy to four intradermal skin antigens. (Candida, tuberculin, Streptokinase-dornase, and mumps) and failure to respond to contact sensitization to dinitrochlorobenzene was present in 60% of the patients. No correlation between cutaneous anergy and protein calorie malnutrition could be demonstrated.     

Protein-calorie malnutrition in squirrel monkeys: adaptive response to calorie deficiency

Control, low-protein, low-calorie, and low-protein-plus-low-calorie diets were fed to 37, 14, 8, and 16 infant squirrel monkeys, respectively, from ages 2-8 wk. The deficient diets were planned to prevent growth and were designed to examine the short- and long-term effects of defined nutritional restrictions on body weight, food intake, hematocrit, plasma albumin, growth hormone, and cortisol concentrations. During the restriction period, plasma albumin levels were significantly decreased in both groups with a protein restriction component: plasma cortisol levels were significantly increased only in the low protein and low calorie groups. No significant group differences were observed for hematocrit or plasma growth hormone. Results of this study indicate that 1) energy restriction did not seem to modify the protein requirement for weight maintenance and 2) animals fed low-protein diets, even in the face of growth failure, have a mechanism for wasting energy.     

Antioxidant status in children with protein-energy malnutrition (PEM) living in Cairo, Egypt.

OBJECTIVES: Free radicals are implicated in many diseases. The rise in free radicals associated with antioxidant deficiency results in tissue damage. The pathogenesis of oedema and anaemia commonly found in children with protein-energy malnutrition (PEM) has been suggested to be caused by an imbalance between the production of toxic radicals and their safe disposal. The aim of this study was to evaluate antioxidant status in children with PEM. DESIGN: A total of 68 children (age range: 3 months to 3 years) living in Cairo, Egypt were recruited. Forty-six of these subjects had different degrees of PEM; they were admitted at the Abo-Elrish Hospital, Cairo. Of these, 26 children had kwashiorkor (KWO) and twenty had marasmus (MAR). Twenty-two age and sex matched healthy well-nourished children were recruited from the local community, and used as controls. METHODS: The antioxidant status of the study population was determined by measuring copper-zinc superoxide dismutase (Cu-Zn, SOD) in red blood cells, glutathione peroxidase (GPX) in whole blood, and ceruloplasmin in plasma. In addition, the plasma levels of trace-elements involving antioxidant activities, such as copper (Cu), zinc (Zn), and selenium (Se) were determined, along with a select group of vitamins. The latter included vitamin A (retinol), vitamin E (alpha-tocopherol) and vitamin C (ascorbic acid). RESULTS: The mean whole blood GPX activity along with plasma levels of vitamins A, E and C as well as ceruloplasmin, Cu and Se were all lower in children with either KWO or MAR than their corresponding control subjects. The erythrocyte SOD activity, on the other hand, was increased while the plasma Zn concentrations were either increased or not changed in the malnourished children. It was of interest that while haemoglobin concentrations were decreased, the plasma free iron (Fe) levels were significantly increased in children with KWO. CONCLUSIONS: The significant increase in red cell SOD activity associated with the decrease in plasma ceruloplasmin, antioxidant vitamins and the whole blood GPX activity in PEM children suggest that these children are potentially susceptible to high oxidative stress. An elevated plasma Fe concentrations, especially with KWO may augment the harmful effect of free radicals with a clinical consequence of oedema.     

Serum proteinase inhibitors and other serum proteins in protein-energy malnutrition.

1. The concentrations of serum protein albumin, prealbumin and transferrin were determined in twenty-eight cases of protein-energy malnutrition (PEM) with infection, together with the levels of serum proteinase inhibitors (PI), alpha1-antitrypsin (AT), alpha1-antichymotrypsin (Ach), alpha2-macroglobulin (alpha2M) and inter-alpha-trypsin inhibitor (IalphaI). 2. Albumin, prealbumin and transferrin concentrations, as well as the levels of PI, IalphaI and alpha2M were found to be lower in cases of PEM associated with infection than the corresponding values for a group of healthy Thai preschool children and a group of newborn Thai children, but despite starvation AT and Ach values generally were increased. 3. The results provide support for the hypothesis that PI, especially AT and Ach might limit the synthesis of albumin, prealbumin and transferrin in PEM associated with infection, via the inhibition of the mobilization of body's own protein.     

The bound carbohydrates of fractionated serum proteins in protein-calorie malnutrition.

Alterations in the carbohydrate composition of serum protein fractions have been determined in pooled sera from 35 children with protein-calorie malnutrition (PCM), 30 children treated for PCM, and 24 age- and social status-matched controls. Total protein-bound hexose (PBH), protein-bound sialic acid (PBSA), and protein-bound fucose (PBF) were elevated in PCM, but only PBF returned to control levels with treatment. Ratios of bound carbohydrate to protein in the unfractioned serum were elevated in PCM but PBH and PBF protein or globulin ratios returned to normal with treatment. The most marked change in carbohydrate composition occurred in the alpha1-globulin fraction. Molar ratios in the individual globulin fractions indicated an increase in carbohydrate moieties as follows: PBSA greater than PBH greater than PBF.     

Child labour in Egypt. I. Occupational and socio-economic aspects

The present study comprised 1000 child and young workers in small and medium-size industries in Alexandria, as well as 250 control subjects. Almost all young workers work for more than 40 hours/week and suffer from fatigue. Workers' family needs rather than the lack of family care is the responsible factor for sending the child to work, and the economic problems seem to be the underlying factor for all other problems of child labour. Work improves labourers' socio-economic status and smoking habit, and provides a chance for their personal contacts and interactions, which are reflected on their level of intellectual capabilities; however, it has some impact on their food habits affecting their achievement of balanced diet; and no drug addiction exists among all the studied subjects. Noise and dust represent the main occupational exposures (84.4% and 55.8% respectively), followed by exposure to heat (25.3%), vapors and gases (10.4%) and biological materials (9.0%), and nearly 2/3 of the workers have combined exposures. Work injuries occurred to 18.4% of the workers and 7.4% had more than one injury during employment; however, nearly 1/3 of the injuries required absenteeism off work and/or hospitalization. The injuries have been typically related to industrial operations, occurring mostly to hands and fingers (80.4%), and are mainly attributed to lack of training (63.0%). The health services presented to the workers are very poor. The study has been concluded by recommending making the work safe, free from hazards, and ergonomically fit to children, providing educational and training services, covering young workers by social security, and revising legislation of child labour.