Malnutrition rehabilitation

In tropical sprue, gluten does not appear to play much part in relatively early cases, such as those studied in Hong Kong. There is evidence, however, that patients with chronic sprue of many years duration may show some improvement on a gluten-free diet (C2). This may be a secondary phenomenon, due to general reduction of the enzymes in the small intestinal mucosa other mucosal enzymes have been shown to be reduced or ineffective in these patients. The important question is whether such patients will still react to gluten when the mucous membrane is brought back to normal by appropriate therapy, if this can be achieved. The rehabilitation of a malnutritional state induced over a period of many years is an extremely complex problem. 

Doherty CP, Sarkar MA, Shakur MS, Ling SC, Elton RA, Cutting WA. Zinc and rehabilitation from severe protein-energy malnutrition higher-dose regimens are associated with increased mortality. Am J Clin Nutr 1998 68 742-8. 

In addition to supplemental oxygen, adjunctive therapies to consider as part of a pulmonary rehabilitation program are psychoeducational care and nutritional support. Psychoeducational care (such as relaxation) has been associated with improvement in the functioning and well-being of adults with COPD."" The role of nutritional support in patients with COPD is controversial. Several studies have shown an association between malnutrition, low body mass index (BMI), and impaired pulmonary status among patients with COPD. However, in... 

TREATMENT AND PREVENTION OF PROTEIN-ENERGY MALNUTRITION. Depending upon the severity of the disorder, the process of rehabilitation may require one or more levels of treatment. The main therapeutic levels follow. 

Opsonic activity for E. coll strains opsonized via either pathway of complement activity was also moderately decreased. Considering the fact that hemolytic complement activity and opsonin levels to these organisms are equal to values found in control patients when acute PEM patients are fully rehabilitated, it must be concluded that baseline complement levels and function are depressed in mild-moderate malnutrition. However, when the presence of recent inflammatory processes was screened by elevation of C-reactive... 

There is now an extensive literature which indicates that the brain function of children malnourished early in life is impaired. Yet it seems unlikely that a direct effect of malnutrition on the brain is the sole cause. Cravioto and his colleagues drew attention to the complexity of the poor social conditions under which such children live. There is experimental evidence that certain aspects of brain growth and development are reduced in animals reared in isolation and that the adverse effects of feeding a low-protein diet can be reduced by increasing the number of animals in a cage . Studies on previously malnourished Korean children adopted into middle-class American families have shown the importance of environmental enrichment in the rehabilitation of such children. 

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