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BACKGROUND

       Recovering  from  a  surgery  a  wound  injury        states of cachexia are associated with underlying

       or  post  debilitating  states  like  Tiberculosis    inammatory process activate protein degradation
       HIV  and  Burns  can  be  challending.  The           and  lipolytic  pathways,  resulting  in  tissue  loss.

       attending clinician will look for likely ways to

       maintain the strength and speed and quality           The branched chain amino acid leucine, the leucine
       of healing and recovery. Increasing the body’s        metabolite  alpha-hydroxy-alpha  methyltbyrate,
                                                             arginine,  glutamine,  3  long  chain  fatty  acids,
       innate immunity to protect against infection,
                                                             conjugrated  linoleic  acid,  and  polyphenols  have
       re-injury and slow healing will make it easier        demostrated  some  efcacy  in  animal  and/or

       for the patient to get active and independent         human  studies.  Optimal  treatment  for  cachexia
       faster as well as to living and loving life again     is likely aimed at maximizing muscle and adipose

                                                             synthesis  while  minimizing  degradation
       Chronic Infections (HIV, TB)
       Chronic Infections (HIV, TB)
       Chronic Infections (HIV  , TB)                            Nutrition is clinical practice, Vol. 21 No.2,155-167 (2006)
       Infectionus  illnesses,  such  as  Tuberculosis
                                                             R
                                                              ecovery F
                                                                                                  rauma:
                                                                         rom Burns, Surgery & T
                                                             Recovery From Burns, Surgery & Trauma:
       and  HIV,  are  accompanied  by  a  complex           Recovery From Burns, Surgery & Trauma:
       variety of nutritional and metabolic response  In  burn  patients  periods  of  convalescence  may
       within the body. The response within the body.        last for several months, resulting in as much of a
       The response to infection is associated with:         physiologic drain on the patient as the acute burn,
       * An increase in the energy expenditure of the        convascence can be greatly shortened by increased

         patient and                                         to optimal nutrition. Injury is followed by a period of
                                                             negative nitrogen balance. This period of negative
       * Various degrees of Tissue breakdown.
                                                             nitrogen balance. This period of catabolism lasts for
       Additionally,  in  the  body’s  attempt  to  ght  the   varing periods of time, depending upon the severity
       infection energy expenditure is increased, therby     of  the  injury.  the  daily  nitrogen  loss  averages  to

       increasing energy needs in the patient. Patients      26.5g or 166g of protein. The daily negative nitrogen
       chrachteristically  present  with  loss  of  appetite   balance averages 10.4g ot 65g of protein.
       and body weight. complex changes occur in the         Immediately  after  injury,  an  adequate  intake  cannot

       metabolism of all the mactronutrients, i.e. protein   be  expected  because  the  patient  is  usually  not  able
       carbohydrate  and  fat.  An  increase  in  protein  to take a full hospital tray. During this period, Nitrogen

       breakdown  for  example  leads  to  muscle  depletion can be minimized by encouraging the patient
       wasting  in  these  patients.  Such  patients  are  to take high protein liquid mixture. the best method of
       also  known  to  have  high  lossed  of  protein  minimizing protein. depletion seems to be by the use of

       (nitrogen),  which  may  result  in  malabsorption    an acceptable high protein, between meal high protein
       due to diarrhoea, loss of uids, electrolytes and     s u p p l e m e n t   i n   l i q u i d   f o r m .
       o t h e r   n u t r i t i o n a l   r e s e r v e s .
                                                             similarly  when  it  comes  to  recovery  from  trauma  &
       Cancer Cachexia :
       Cancer Cachexia :
       Cancer Cachexia :
       Cachexia  represent  progressive  wasting  of         surgery,  there’s  the  obvious  emotional  and  physicial
                                                             stress compounded by the stress caused by the actual
       muscle  and  adipose  tissue  and  is  associated
       with  increased  morbidity  and  mortality,  althrough  disease or trauma. inevitably, pain killer, drugs and sleep
       anorexia  usually  accompanies  canchexia  rarely     deprivation all add to the stress load, (See chart in next
       responds to increased food intake alone. Our knowledge  page)
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