SlideShare una empresa de Scribd logo
1 de 14
Agathe Raynaud-Simon Service de Gériatrie, H ôpital Bichat APHP, Paris Faculté de Médecine Denis Diderot, Paris 7 Laboratoire de Biologie de la Nutrition, EA4466, Faculté de Pharmacie, Paris 5 Evaluation  of  malnutrition
Malnutrition
Malnutrition and mortality ,[object Object],[object Object],[object Object],[object Object],[object Object]
Assessment of malnutrition ,[object Object],[object Object],[object Object]
Risk factors for malnutrition Cancer Cardiac Respiratory Liver Renal Chronic infections Chronic inflammation Malabsorption Maldigestion Failure ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Psychiatric disorders Disability Swallowing disorders ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Neurologic Restrictive diets Mouth and teeth ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Drugs Acute conditions, Worsening of a chronic condition Psychologic, social and environement
Risk factors for malnutrition Cancer Cardiac Respiratory Liver Renal Chronic infections Chronic inflammation Malabsorption Maldigestion Failure ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Psychiatric disorders Disability Swallowing disorders ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Neurologic Restrictive diets Mouth and teeth ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Drugs Acute conditions, Worsening of a chronic condition Psychologic, social and environement
Evaluation of food intake
Nutritional parameters and life-threatening complications in geriatric patients   Sullivan DH et al, J Gen Intern Med  2002; 17: 923 - 932 4,0% ≥  22 kg/m ² 0,008 15,4% BMI   < 22 kg/m ² 4,6% ≥  18 mg/dL   0,046 10,5% Transthyretin  < 18 mg/dL 5,3% ≥  30 g/L 0,018 13,3% Albumin   < 30 g/L  4,5% no <0,001 19% Weight loss   > 5 %   yes 3,2% > 323 mm 2,4% 286 – 323 mm <0,001 13,8% MAC  < 286 mm P-Wert Complication rate Parameter
Malnutrition « Marasmus » Progressiv weight loss Protein and energy deficiency Muscle and fat loss Normal albuminemia No edema « Kwashiorkor » Rapid weight loss Protein deficiency Muscle mass loss Hypoalbuminemia Edema
Volkert D et al. Aktuel Ernaehr Med 2004; 29: 190-197 40 % 82    5 215 acute care, mixt Volkert (1992) 33 % 79    6 110 rehabilitation Sullivan (1994) 22 % 79    6 302 acute care, mixt Incalzi (1996) < 22 52 % 80    7 42 hip fracture Ponzer (1999) 35 % 83    4 99 acute care, mixt Dormenval (1999) 8 % > 70 116 ICU (respirator) Dardaine (2001)  < 21 36 % 81    1 337 acute care, mixt Flodin (2000)    20 36 % 80    7 42 hip fracture Ponzer (1999) 31 % 78    9 201 stroke Gariballa (1998) 26 % 62 95 Parkinson Markus (1993) 21 % 82    5 215 acute care, mixt Volkert (1992) < 20 17 %    65 127 acute care, mixt DaCunha (2001) < 18,5 31 % 80    9 119 hip fracture Maffuli (1999) 9 % 82    5 215 acute care, mixt Volkert (1992) < 18 11 % 80    9 119 hip fracture Maffuli (1999) < 16 prevalence age n patients author BMI
Malnutrition criteria ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Mini- MNA - risk factors - appetite - nutritional criteria  NEW ! Kaiser, JNHA 2009
[object Object],[object Object],[object Object],Geriatric  Nutritional Risk Index Bouillanne et al, Am J Clin Nut, 2005
Assessment  of nutritional status Body storage Weight, BMI How much fat? How much muscle? Metabolic homeostasis Albuminemia? Glycemia? Ca? P? …

Más contenido relacionado

La actualidad más candente

Indications & c.i in bariatric surgery
Indications & c.i in bariatric surgeryIndications & c.i in bariatric surgery
Indications & c.i in bariatric surgeryDr Sumeet Shah
 
Nutrition and MSK Health
Nutrition and MSK Health Nutrition and MSK Health
Nutrition and MSK Health EsserHealth
 
Metabolic Syndrome, Diabetes, and Cardiovascular Disease ... Metabolic Synd...
Metabolic Syndrome, Diabetes, and Cardiovascular Disease ... 	 Metabolic Synd...Metabolic Syndrome, Diabetes, and Cardiovascular Disease ... 	 Metabolic Synd...
Metabolic Syndrome, Diabetes, and Cardiovascular Disease ... Metabolic Synd...MedicineAndFamily
 
Why What You Do Matters: The Intersection of Movement, Food and Orthopedic N...
Why What You Do Matters:  The Intersection of Movement, Food and Orthopedic N...Why What You Do Matters:  The Intersection of Movement, Food and Orthopedic N...
Why What You Do Matters: The Intersection of Movement, Food and Orthopedic N...EsserHealth
 
Bariatric Surgery: Options, Trends, and Latest Innovations
Bariatric Surgery: Options, Trends, and Latest InnovationsBariatric Surgery: Options, Trends, and Latest Innovations
Bariatric Surgery: Options, Trends, and Latest InnovationsGeorge S. Ferzli
 
The Power of Personal Choice 2020
The Power of Personal Choice 2020The Power of Personal Choice 2020
The Power of Personal Choice 2020EsserHealth
 
Bariatric surgery powerpoint
Bariatric surgery powerpointBariatric surgery powerpoint
Bariatric surgery powerpointjason rivera
 
Dr Pradeep Jain Reviews, Fortis Hospital - Why, Who, When and What of Weight ...
Dr Pradeep Jain Reviews, Fortis Hospital - Why, Who, When and What of Weight ...Dr Pradeep Jain Reviews, Fortis Hospital - Why, Who, When and What of Weight ...
Dr Pradeep Jain Reviews, Fortis Hospital - Why, Who, When and What of Weight ...Dr Pradeep Jain Reviews
 
01&02 rencontres biomédicale Christian Boitard
01&02 rencontres biomédicale Christian Boitard01&02 rencontres biomédicale Christian Boitard
01&02 rencontres biomédicale Christian BoitardAssociation LIR
 
Metabolic Syndrome and Dietary Guidelines for its prevention
Metabolic Syndrome and Dietary Guidelines for its preventionMetabolic Syndrome and Dietary Guidelines for its prevention
Metabolic Syndrome and Dietary Guidelines for its preventionnutritionistrepublic
 
Metabolic abnormalities observed in osteoarthritis of knee: A single center e...
Metabolic abnormalities observed in osteoarthritis of knee: A single center e...Metabolic abnormalities observed in osteoarthritis of knee: A single center e...
Metabolic abnormalities observed in osteoarthritis of knee: A single center e...Apollo Hospitals
 
Publication list November 2016
Publication list November 2016Publication list November 2016
Publication list November 2016Farid Mirshahi
 
Renal nutrition, frailty and aging
Renal nutrition, frailty and agingRenal nutrition, frailty and aging
Renal nutrition, frailty and agingMary Hickson
 
Risco Cardiovascular e Cirurgia Bariátrica
Risco Cardiovascular e Cirurgia BariátricaRisco Cardiovascular e Cirurgia Bariátrica
Risco Cardiovascular e Cirurgia BariátricaCaetano Marchesini
 
The Role of Bariatric Surgery on Brain and Reward
The Role of Bariatric Surgery on Brain and RewardThe Role of Bariatric Surgery on Brain and Reward
The Role of Bariatric Surgery on Brain and RewardRiverMend Health
 
Management of t2 dm beyond glycemic control
Management of t2 dm  beyond glycemic controlManagement of t2 dm  beyond glycemic control
Management of t2 dm beyond glycemic controlalaa wafa
 

La actualidad más candente (20)

Indications & c.i in bariatric surgery
Indications & c.i in bariatric surgeryIndications & c.i in bariatric surgery
Indications & c.i in bariatric surgery
 
PATHOPHYSIOLOGY OF BARIATRIC SURGERY
PATHOPHYSIOLOGY OF BARIATRIC SURGERYPATHOPHYSIOLOGY OF BARIATRIC SURGERY
PATHOPHYSIOLOGY OF BARIATRIC SURGERY
 
Nutrition and MSK Health
Nutrition and MSK Health Nutrition and MSK Health
Nutrition and MSK Health
 
Metabolic Syndrome, Diabetes, and Cardiovascular Disease ... Metabolic Synd...
Metabolic Syndrome, Diabetes, and Cardiovascular Disease ... 	 Metabolic Synd...Metabolic Syndrome, Diabetes, and Cardiovascular Disease ... 	 Metabolic Synd...
Metabolic Syndrome, Diabetes, and Cardiovascular Disease ... Metabolic Synd...
 
Cancer 2018
Cancer 2018Cancer 2018
Cancer 2018
 
Why What You Do Matters: The Intersection of Movement, Food and Orthopedic N...
Why What You Do Matters:  The Intersection of Movement, Food and Orthopedic N...Why What You Do Matters:  The Intersection of Movement, Food and Orthopedic N...
Why What You Do Matters: The Intersection of Movement, Food and Orthopedic N...
 
Bariatric Surgery: Options, Trends, and Latest Innovations
Bariatric Surgery: Options, Trends, and Latest InnovationsBariatric Surgery: Options, Trends, and Latest Innovations
Bariatric Surgery: Options, Trends, and Latest Innovations
 
The Power of Personal Choice 2020
The Power of Personal Choice 2020The Power of Personal Choice 2020
The Power of Personal Choice 2020
 
Bariatric surgery powerpoint
Bariatric surgery powerpointBariatric surgery powerpoint
Bariatric surgery powerpoint
 
Metabolic syndrome
Metabolic syndromeMetabolic syndrome
Metabolic syndrome
 
Dr Pradeep Jain Reviews, Fortis Hospital - Why, Who, When and What of Weight ...
Dr Pradeep Jain Reviews, Fortis Hospital - Why, Who, When and What of Weight ...Dr Pradeep Jain Reviews, Fortis Hospital - Why, Who, When and What of Weight ...
Dr Pradeep Jain Reviews, Fortis Hospital - Why, Who, When and What of Weight ...
 
01&02 rencontres biomédicale Christian Boitard
01&02 rencontres biomédicale Christian Boitard01&02 rencontres biomédicale Christian Boitard
01&02 rencontres biomédicale Christian Boitard
 
Metabolic Syndrome and Dietary Guidelines for its prevention
Metabolic Syndrome and Dietary Guidelines for its preventionMetabolic Syndrome and Dietary Guidelines for its prevention
Metabolic Syndrome and Dietary Guidelines for its prevention
 
Metabolic abnormalities observed in osteoarthritis of knee: A single center e...
Metabolic abnormalities observed in osteoarthritis of knee: A single center e...Metabolic abnormalities observed in osteoarthritis of knee: A single center e...
Metabolic abnormalities observed in osteoarthritis of knee: A single center e...
 
Publication list November 2016
Publication list November 2016Publication list November 2016
Publication list November 2016
 
501
501501
501
 
Renal nutrition, frailty and aging
Renal nutrition, frailty and agingRenal nutrition, frailty and aging
Renal nutrition, frailty and aging
 
Risco Cardiovascular e Cirurgia Bariátrica
Risco Cardiovascular e Cirurgia BariátricaRisco Cardiovascular e Cirurgia Bariátrica
Risco Cardiovascular e Cirurgia Bariátrica
 
The Role of Bariatric Surgery on Brain and Reward
The Role of Bariatric Surgery on Brain and RewardThe Role of Bariatric Surgery on Brain and Reward
The Role of Bariatric Surgery on Brain and Reward
 
Management of t2 dm beyond glycemic control
Management of t2 dm  beyond glycemic controlManagement of t2 dm  beyond glycemic control
Management of t2 dm beyond glycemic control
 

Similar a Raynaud

1 yini salas-salvado - yogurt and diabetes - 2015 - san diego
1 yini   salas-salvado - yogurt and diabetes - 2015 - san diego1 yini   salas-salvado - yogurt and diabetes - 2015 - san diego
1 yini salas-salvado - yogurt and diabetes - 2015 - san diegoCharlotte Baecke
 
Lean in Primary Care - Redesigning the Diabetes Process
Lean in Primary Care - Redesigning the Diabetes ProcessLean in Primary Care - Redesigning the Diabetes Process
Lean in Primary Care - Redesigning the Diabetes ProcessLean Enterprise Academy
 
Androgens & Cardiovascular Diseases in Women: From Basic Research to Clinical...
Androgens & Cardiovascular Diseases in Women: From Basic Research to Clinical...Androgens & Cardiovascular Diseases in Women: From Basic Research to Clinical...
Androgens & Cardiovascular Diseases in Women: From Basic Research to Clinical...InsideScientific
 
Best diet for heart disease.ppt
Best diet for heart disease.pptBest diet for heart disease.ppt
Best diet for heart disease.pptlaxmangyawali2
 
Epidemiology of diabetes mellitus
Epidemiology of diabetes mellitusEpidemiology of diabetes mellitus
Epidemiology of diabetes mellitusmgmcricommunitymed
 
The hitchhiker’s guide to tpn
The hitchhiker’s guide to tpnThe hitchhiker’s guide to tpn
The hitchhiker’s guide to tpnEd McDonald
 
Importance of nutrition in hospitalized patients
Importance of nutrition in hospitalized patientsImportance of nutrition in hospitalized patients
Importance of nutrition in hospitalized patientsAzam Jafri
 
Chronic Kidney disease Diet Therapy
Chronic Kidney disease Diet TherapyChronic Kidney disease Diet Therapy
Chronic Kidney disease Diet TherapyTimothy Zagada
 
Diabetes and Periodontal Disease The Relation
Diabetes and Periodontal Disease The RelationDiabetes and Periodontal Disease The Relation
Diabetes and Periodontal Disease The Relationceo_dentalsurgery
 
Slowing Progression of Chronic Kidney Disease Through Value-Based Care
Slowing Progression of Chronic Kidney Disease Through Value-Based CareSlowing Progression of Chronic Kidney Disease Through Value-Based Care
Slowing Progression of Chronic Kidney Disease Through Value-Based Carei3 Health
 
Metabolic syndrome november 2014
Metabolic syndrome november 2014Metabolic syndrome november 2014
Metabolic syndrome november 2014 Mohamed BADR
 

Similar a Raynaud (20)

Metabolic Complications
Metabolic ComplicationsMetabolic Complications
Metabolic Complications
 
NutriNar
NutriNarNutriNar
NutriNar
 
Obesity
ObesityObesity
Obesity
 
Strive Teleconf Presentation Oct11 2006
Strive Teleconf Presentation Oct11 2006Strive Teleconf Presentation Oct11 2006
Strive Teleconf Presentation Oct11 2006
 
1 yini salas-salvado - yogurt and diabetes - 2015 - san diego
1 yini   salas-salvado - yogurt and diabetes - 2015 - san diego1 yini   salas-salvado - yogurt and diabetes - 2015 - san diego
1 yini salas-salvado - yogurt and diabetes - 2015 - san diego
 
Managing Type 2 Diabetes
Managing Type 2 DiabetesManaging Type 2 Diabetes
Managing Type 2 Diabetes
 
Presentation final montanya
Presentation final montanyaPresentation final montanya
Presentation final montanya
 
DIABETIC NEPHROPATHY
DIABETIC NEPHROPATHYDIABETIC NEPHROPATHY
DIABETIC NEPHROPATHY
 
Lean in Primary Care - Redesigning the Diabetes Process
Lean in Primary Care - Redesigning the Diabetes ProcessLean in Primary Care - Redesigning the Diabetes Process
Lean in Primary Care - Redesigning the Diabetes Process
 
Androgens & Cardiovascular Diseases in Women: From Basic Research to Clinical...
Androgens & Cardiovascular Diseases in Women: From Basic Research to Clinical...Androgens & Cardiovascular Diseases in Women: From Basic Research to Clinical...
Androgens & Cardiovascular Diseases in Women: From Basic Research to Clinical...
 
Best diet for heart disease.ppt
Best diet for heart disease.pptBest diet for heart disease.ppt
Best diet for heart disease.ppt
 
Epidemiology of diabetes mellitus
Epidemiology of diabetes mellitusEpidemiology of diabetes mellitus
Epidemiology of diabetes mellitus
 
The hitchhiker’s guide to tpn
The hitchhiker’s guide to tpnThe hitchhiker’s guide to tpn
The hitchhiker’s guide to tpn
 
Importance of nutrition in hospitalized patients
Importance of nutrition in hospitalized patientsImportance of nutrition in hospitalized patients
Importance of nutrition in hospitalized patients
 
Pdf Diabetes for nurses
Pdf   Diabetes for nursesPdf   Diabetes for nurses
Pdf Diabetes for nurses
 
Chronic Kidney disease Diet Therapy
Chronic Kidney disease Diet TherapyChronic Kidney disease Diet Therapy
Chronic Kidney disease Diet Therapy
 
Diabetes and Periodontal Disease The Relation
Diabetes and Periodontal Disease The RelationDiabetes and Periodontal Disease The Relation
Diabetes and Periodontal Disease The Relation
 
Slowing Progression of Chronic Kidney Disease Through Value-Based Care
Slowing Progression of Chronic Kidney Disease Through Value-Based CareSlowing Progression of Chronic Kidney Disease Through Value-Based Care
Slowing Progression of Chronic Kidney Disease Through Value-Based Care
 
Metabolic syndrome november 2014
Metabolic syndrome november 2014Metabolic syndrome november 2014
Metabolic syndrome november 2014
 
obesity diabetes and metabolic syndrome
obesity diabetes and metabolic syndromeobesity diabetes and metabolic syndrome
obesity diabetes and metabolic syndrome
 

Más de evivoudiklari (15)

Papanikolaou
PapanikolaouPapanikolaou
Papanikolaou
 
Dionyssiotis
DionyssiotisDionyssiotis
Dionyssiotis
 
Bollheimer
BollheimerBollheimer
Bollheimer
 
Spatharakis 2
Spatharakis 2Spatharakis 2
Spatharakis 2
 
Bollheimer
BollheimerBollheimer
Bollheimer
 
Raynaud
RaynaudRaynaud
Raynaud
 
Benetos 2
Benetos 2Benetos 2
Benetos 2
 
Benetos 1
Benetos 1Benetos 1
Benetos 1
 
Spatharakis
SpatharakisSpatharakis
Spatharakis
 
Queneau
QueneauQueneau
Queneau
 
Rolland
RollandRolland
Rolland
 
Zamboni
ZamboniZamboni
Zamboni
 
Tsolaki
TsolakiTsolaki
Tsolaki
 
Onder
OnderOnder
Onder
 
1 rolland
1 rolland1 rolland
1 rolland
 

Último

Call Girls Mumbai Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Mumbai Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Mumbai Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Mumbai Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Ahmedabad Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Ahmedabad Just Call 9630942363 Top Class Call Girl Service AvailableCall Girls Ahmedabad Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Ahmedabad Just Call 9630942363 Top Class Call Girl Service AvailableGENUINE ESCORT AGENCY
 
Call Girls in Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service Avai...
Call Girls in Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service Avai...Call Girls in Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service Avai...
Call Girls in Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service Avai...adilkhan87451
 
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...Anamika Rawat
 
Call Girls Madurai Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Madurai Just Call 9630942363 Top Class Call Girl Service AvailableCall Girls Madurai Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Madurai Just Call 9630942363 Top Class Call Girl Service AvailableGENUINE ESCORT AGENCY
 
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...Sheetaleventcompany
 
Call Girls Jaipur Just Call 9521753030 Top Class Call Girl Service Available
Call Girls Jaipur Just Call 9521753030 Top Class Call Girl Service AvailableCall Girls Jaipur Just Call 9521753030 Top Class Call Girl Service Available
Call Girls Jaipur Just Call 9521753030 Top Class Call Girl Service AvailableJanvi Singh
 
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any TimeTop Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any TimeCall Girls Delhi
 
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls  * UPA...Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls  * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...mahaiklolahd
 
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...tanya dube
 
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...adilkhan87451
 
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...parulsinha
 
Kollam call girls Mallu aunty service 7877702510
Kollam call girls Mallu aunty service 7877702510Kollam call girls Mallu aunty service 7877702510
Kollam call girls Mallu aunty service 7877702510Vipesco
 
Dehradun Call Girls Service {8854095900} ❤️VVIP ROCKY Call Girl in Dehradun U...
Dehradun Call Girls Service {8854095900} ❤️VVIP ROCKY Call Girl in Dehradun U...Dehradun Call Girls Service {8854095900} ❤️VVIP ROCKY Call Girl in Dehradun U...
Dehradun Call Girls Service {8854095900} ❤️VVIP ROCKY Call Girl in Dehradun U...Sheetaleventcompany
 
Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...
Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...
Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...Sheetaleventcompany
 
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...Ishani Gupta
 
Call Girls Coimbatore Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Coimbatore Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...parulsinha
 
Coimbatore Call Girls in Coimbatore 7427069034 genuine Escort Service Girl 10...
Coimbatore Call Girls in Coimbatore 7427069034 genuine Escort Service Girl 10...Coimbatore Call Girls in Coimbatore 7427069034 genuine Escort Service Girl 10...
Coimbatore Call Girls in Coimbatore 7427069034 genuine Escort Service Girl 10...chennailover
 

Último (20)

Call Girls Mumbai Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Mumbai Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Mumbai Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Mumbai Just Call 8250077686 Top Class Call Girl Service Available
 
Call Girls Ahmedabad Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Ahmedabad Just Call 9630942363 Top Class Call Girl Service AvailableCall Girls Ahmedabad Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Ahmedabad Just Call 9630942363 Top Class Call Girl Service Available
 
Call Girls in Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service Avai...
Call Girls in Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service Avai...Call Girls in Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service Avai...
Call Girls in Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service Avai...
 
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
 
Call Girls Madurai Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Madurai Just Call 9630942363 Top Class Call Girl Service AvailableCall Girls Madurai Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Madurai Just Call 9630942363 Top Class Call Girl Service Available
 
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...
 
Call Girls Jaipur Just Call 9521753030 Top Class Call Girl Service Available
Call Girls Jaipur Just Call 9521753030 Top Class Call Girl Service AvailableCall Girls Jaipur Just Call 9521753030 Top Class Call Girl Service Available
Call Girls Jaipur Just Call 9521753030 Top Class Call Girl Service Available
 
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any TimeTop Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
 
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls  * UPA...Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls  * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
 
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
 
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
 
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
 
Kollam call girls Mallu aunty service 7877702510
Kollam call girls Mallu aunty service 7877702510Kollam call girls Mallu aunty service 7877702510
Kollam call girls Mallu aunty service 7877702510
 
Dehradun Call Girls Service {8854095900} ❤️VVIP ROCKY Call Girl in Dehradun U...
Dehradun Call Girls Service {8854095900} ❤️VVIP ROCKY Call Girl in Dehradun U...Dehradun Call Girls Service {8854095900} ❤️VVIP ROCKY Call Girl in Dehradun U...
Dehradun Call Girls Service {8854095900} ❤️VVIP ROCKY Call Girl in Dehradun U...
 
Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...
Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...
Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...
 
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
 
Call Girls Coimbatore Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Coimbatore Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 8250077686 Top Class Call Girl Service Available
 
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
 
🌹Attapur⬅️ Vip Call Girls Hyderabad 📱9352852248 Book Well Trand Call Girls In...
🌹Attapur⬅️ Vip Call Girls Hyderabad 📱9352852248 Book Well Trand Call Girls In...🌹Attapur⬅️ Vip Call Girls Hyderabad 📱9352852248 Book Well Trand Call Girls In...
🌹Attapur⬅️ Vip Call Girls Hyderabad 📱9352852248 Book Well Trand Call Girls In...
 
Coimbatore Call Girls in Coimbatore 7427069034 genuine Escort Service Girl 10...
Coimbatore Call Girls in Coimbatore 7427069034 genuine Escort Service Girl 10...Coimbatore Call Girls in Coimbatore 7427069034 genuine Escort Service Girl 10...
Coimbatore Call Girls in Coimbatore 7427069034 genuine Escort Service Girl 10...
 

Raynaud

  • 1. Agathe Raynaud-Simon Service de Gériatrie, H ôpital Bichat APHP, Paris Faculté de Médecine Denis Diderot, Paris 7 Laboratoire de Biologie de la Nutrition, EA4466, Faculté de Pharmacie, Paris 5 Evaluation of malnutrition
  • 3.
  • 4.
  • 5.
  • 6.
  • 8. Nutritional parameters and life-threatening complications in geriatric patients Sullivan DH et al, J Gen Intern Med 2002; 17: 923 - 932 4,0% ≥ 22 kg/m ² 0,008 15,4% BMI < 22 kg/m ² 4,6% ≥ 18 mg/dL 0,046 10,5% Transthyretin < 18 mg/dL 5,3% ≥ 30 g/L 0,018 13,3% Albumin < 30 g/L 4,5% no <0,001 19% Weight loss > 5 % yes 3,2% > 323 mm 2,4% 286 – 323 mm <0,001 13,8% MAC < 286 mm P-Wert Complication rate Parameter
  • 9. Malnutrition « Marasmus » Progressiv weight loss Protein and energy deficiency Muscle and fat loss Normal albuminemia No edema « Kwashiorkor » Rapid weight loss Protein deficiency Muscle mass loss Hypoalbuminemia Edema
  • 10. Volkert D et al. Aktuel Ernaehr Med 2004; 29: 190-197 40 % 82  5 215 acute care, mixt Volkert (1992) 33 % 79  6 110 rehabilitation Sullivan (1994) 22 % 79  6 302 acute care, mixt Incalzi (1996) < 22 52 % 80  7 42 hip fracture Ponzer (1999) 35 % 83  4 99 acute care, mixt Dormenval (1999) 8 % > 70 116 ICU (respirator) Dardaine (2001) < 21 36 % 81  1 337 acute care, mixt Flodin (2000)  20 36 % 80  7 42 hip fracture Ponzer (1999) 31 % 78  9 201 stroke Gariballa (1998) 26 % 62 95 Parkinson Markus (1993) 21 % 82  5 215 acute care, mixt Volkert (1992) < 20 17 %  65 127 acute care, mixt DaCunha (2001) < 18,5 31 % 80  9 119 hip fracture Maffuli (1999) 9 % 82  5 215 acute care, mixt Volkert (1992) < 18 11 % 80  9 119 hip fracture Maffuli (1999) < 16 prevalence age n patients author BMI
  • 11.
  • 12. Mini- MNA - risk factors - appetite - nutritional criteria NEW ! Kaiser, JNHA 2009
  • 13.
  • 14. Assessment of nutritional status Body storage Weight, BMI How much fat? How much muscle? Metabolic homeostasis Albuminemia? Glycemia? Ca? P? …

Notas del editor

  1. The prevalence rates in the different studies therefore differs widely as a consequence of the different parameters used for the diagnosis of malnutrition . For example these are some the data for the BMI. The rates differ according to different cut off values. Look at the data provided by Volkert and collegues. The chose a population of patients from acute care. The prevalence if they use a cut off value of 18 or 22.