Catabolic illness: strategies for enhancing recovery

Article Abstract:

Infection and injury often cause rapid weight loss, but it is usually self-limited and inconsequential. However, a prolonged illness resulting in nutritional depletion may depress the immune system, increasing the likelihood of contracting a hospital-borne (nosocomial) infection and causing delayed wound healing and tissue repair. Loss of strength may cause serious problems in patients who are to be weaned from mechanical ventilators, or lead to thrombophlebitis (inflammation and the formation of a blood clot in a vein) and potentially fatal pulmonary embolism (clotted tissue that travels in the circulation and lodges in a lung). At a minimum, self-care is difficult in these patients, convalescence is prolonged, and recovery is delayed. The ill effects of nutritional depletion, especially those associated with catabolism (a metabolic process that converts complex substances into simpler ones, creating energy) are discussed in detail. Catabolism can be modified by altering the nutritional support of patients according to changes wrought by catabolic diseases. Among the amino acids depleted by catabolic illnesses are glutamine, arginine and branched chain amino acids; these substances and certain fats can be added to the diet. Omega-3 fatty acids, uncommon in Western diets, are recommended for patients with such illnesses. Recombinant forms of growth factors that enhance protein synthesis and facilitate tissue repair may also be beneficial to recovery. The optimal combination of therapies for specific diseases and types of injuries needs to be determined. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Physiological aspects, Chronic diseases, Metabolism, Human nutrition, Artificial feeding, Feeding methods, Amino acids, Omega-3 fatty acids, Omega 3 fatty acids, Amino acids in human nutrition

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Occupational illness

Article Abstract:

Occupational illnesses can be prevented, particularly if physicians become proficient at diagnosing them. Diagnosis of work-related illnesses can be improved if physicians briefly question patients about their work, rule out non-occupational illnesses, and consult occupational medicine specialists. In some cases, diagnosis can be made based on medical tests, such as blood tests for lead. Information on the toxic effects of chemicals may be obtained from employers' Material Safety Data Sheets, textbooks, public health agencies, and online databases. Following diagnoses, companies and public health authorities may institute changes in working conditions to prevent such illnesses. Physicians should learn as much as possible about a patient's work conditions before advising them to restrict their work.

Occupational diseases

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High-altitude illness

Article Abstract:

The diagnosis, treatment, and prevention of mountain sickness, high-altitude cerebral edema, and high-altitude pulmonary edema are reviewed. Treatments evaluated include oxygen, hyperbaric oxygen, acetazolamide, dexamethasone, furosemide, nifedipine, NSAIDs, aspirin, ibuprofen, Gingko biloba, antiemetics, prochlorperazine, promethazine, and zolpidem.

Mountain sickness, Altitude sickness

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