Daily partition of urinary nitrogen and nitrogen balance during treatment of protein-depleted infants

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Kwashiorkor and Intellectual Development

Forty Cape Coloured children who had been hospitalized for kwashiorkor in infancy were compared with their siblings on an intelligence test battery at the 10th year of follow-up. No significant differences in intelligence test performance were noted. A significant discrepancy between the intelligence test score and the drawing score in late-onset cases may be due to affective factors. The groups were similar in terms of height, weight and head circumference. The differences between well nourished and poorly nourished groups found by previous investigators may be accounted for by the independent operation of non-nutritive variables in the social and emotional environment. The use of intrafamilial controls in the present study minimized these influences, as well as possible genetic factors in intellectual development.S. Afr. Med. J., 45, 1413 (1971

Kwashiorkor: A Prospective Ten-Year Follow-up Study

The physical status of 123 cases of kwashiorkor, followed up longitudinally for 10 years, was analysed. Their status was compared with that of 97 control siblings who had never suffered from kwashiorkor, but who had grown up under the same environmental conditions as the expatients. It was found that 10 years after the episode of kwashiorkor about half of the children had reached international growth standards in weight and height, thus demonstrating the capacity for complete physical recovery. No significant anthropometric or biochemical differences were found between ex-patients and control siblings at the 10-year follow-up examination. This is adequate proof that the episode of kwashiorkor per se cannot be held responsible for the growth retardation that occurred in some of the children. The children who were most severely retarded in weight and height on admission tended to remain the most severely retarded in growth after 10 years. The children who were the oldest on admission were more retarded in weight after 10 years than the children who were admitted at a younger age. Although these facts may imply that the severity and possibly the duration of the malnutrition episode adversely affected subsequent physical growth, a high current incidence of hypoalbuminaemia was found in both ex-patients and control siblings, indicating continuing malnutrition, the effects of which cannot be separated from possible deleterious effects of thil original malnutrition episode. Linear growth also correlated significantly with midparental height and a complex of adverse social circumstances.Failure to attain international growth standards in some of the children was therefore apparently due to a combination of factors and at present it is impossible to distinguish any single one of these as being more important than the others. Since about half of the children did reach adequate growth standards despite their poor living conditions, it is clearly worth while to treat every case of malnutrition. At the same time public health supervision and preventative social measures should be greatly increased to protect the child population throughout the growing period. S. Afr. Med. J., 45, 1427 (1971

Review of the mathematical foundations of data fusion techniques in surface metrology

The recent proliferation of engineered surfaces, including freeform and structured surfaces, is challenging current metrology techniques. Measurement using multiple sensors has been proposed to achieve enhanced benefits, mainly in terms of spatial frequency bandwidth, which a single sensor cannot provide. When using data from different sensors, a process of data fusion is required and there is much active research in this area. In this paper, current data fusion methods and applications are reviewed, with a focus on the mathematical foundations of the subject. Common research questions in the fusion of surface metrology data are raised and potential fusion algorithms are discussed

Protein-energy malnutrition in cystic fibrosis patients

Protein-energy malnutrition with associated specific nutrient deficiencies is an important feature of cystic fibrosis and has been recognized as a poor prognostic factor. Therefore, the nutritional status of cystic fibrosis patients has to be evaluated regularly by diet diaries, clinical evaluation, anthropometry and more sophisticated methods, such as bioelectrical impedance analysis. Nutritional management, including nutritional rehabilitation programmes, of cystic fibrosis patients is well established today. Consequently, protein-energy malnutrition is no longer acceptable in cystic fibrosis patients, except perhaps in end-stage disease when lung transplantation is not considered

Critical appraisal of the management of severe malnutrition: 2. Dietary management

Abstract: In the dietary management of severe acute malnutrition in children, there is evidence to support the WHO Manual's protocol of cautious feeding of a low energy and protein formula with small frequent feeds in the initial phase of treatment, particularly in kwashiorkor. However, this initial milk diet (WHO F-75) might benefit from increasing the sulphur amino acid, phosphorus and potassium content and reducing the lactose content, but further studies are needed. Careful tube-feeding results in faster initial recovery and weight gain, but has a significant risk of aspiration in poorly supervised settings. Ready-to-use therapeutic food is an important recent advance in the dietary management of malnutrition in ambulatory settings, allowing more effective prevention programmes and earlier discharge from hospital where community follow-up is available. It should be included in future protocols. There is very good evidence on the use of micronutrients such as zinc, and preliminary evidence suggests that smaller doses of daily vitamin A are preferable to a single large dose on admission for severe malnutrition