Acute Malnutrition in Children: Pathophysiology, Clinical Effects and Treatment

Acute malnutrition is a nutritional deficiency resulting from either inadequate energy or protein intake. Children with primary acute malnutrition are common in developing countries as a result of inadequate food supply caused by social, economic, and environmental factors. Secondary acute malnutrition is usually due to an underlying disease causing abnormal nutrient loss, increased energy expenditure, or decreased food intake. Acute malnutrition leads to biochemical changes based on metabolic, hormonal, and glucoregulatory mechanisms. Most children with primary acute malnutrition can be managed at home with nutrition-specific interventions (i.e., counseling of parents, ensuring household food security, etc.). In case of severe acute malnutrition and complications, inpatient treatment is recommended. Secondary acute malnutrition should be managed by treating the underlying cause.

Does Hunger Cause Obesity?

Both hunger and obesity occur with an increased frequency among poorer populations in the United States.1-6 Because obesity connotes excessive energy intake, and hunger reflects an inadequate food supply, the increased prevalence of obesity and hunger in the same population seems paradoxical. Although a variety of environmental, social, behavioral, or physiologic mechanisms could cause both problems independently, an alternative possibility is that hunger and obesity are causally related. The following case report supports this hypothesis. CASE REPORT A.B. (not her real initials) was a 7-year-old African American girl first brought to the Weight Control Program of the Boston Floating Hospital in December 1992.

Some factors affecting the respiration of intertidal Asterina gibbosa (Echinodermata: Asteroidea)

In Britain, the cushion star Asterina gibbosa Pennant 1897 (Echinodermata, Asteroidea) is confined to the west coast, where it occurs on rocky shores, often sympatrically with the closely related Asterina phylactica Emson & Crump 1979 (Crump & Emson, 1983; Emson & Crump, 1984). The vertical distribution of A. gibbosa extends from about 100 m depth, into the intertidal; however, littoral cushion stars occupy rock pools and relatively damp habitats such as gulley walls, crevices, overhangs and the underside of boulders, generally on the lower shore (Emson, 1979). On shores with rock pools, cushion stars may extend their upper limits of vertical distribution but not beyond the mean high-water neap-tide level (Crump & Emson, 1978). Absence of A. gibbosa from higher shore levels has been related to intolerance to desiccation and high temperature, inadequate food supply, and complex behavioural responses to gravity and light (Crozier, 1935; Emson, 1979; Crump & Emson, 1983). Prior to the present study, it has not been possible to discuss the influence of respiratory requirements on the vertical distribution of this species.