Medicinski vjesnik, Vol. 32 No. (1-4), 2000.
Stručni rad
Adults and elderly in clinical practice
Berislav Momčilović
Sažetak
The paper presents modern methods of determination of the nutritive status of adult and elderly people in clinical practice. It emphasizes the key role of anamnestic assessment of the nutritive status as well as of appropriate questionnaries, serving as basic tools to choose among complex differential diagnostic procedures. Anthroometric measurements in the assessment of the nutritive status are worked out in details - body height and weight, triceps fat fold and arm muscle circumference along with the given referential values. Special attention is drawn to the critical evaluation of referential values in clinical practice, when they have to be compared against values of individual patients. Clinical methods to determine the nutritive status are also presented. They may not be able to specify the exact cause, but if used appropriately, are sensitive enough to differentiate between malnutrition/obesity. There are also several available biochemical procedures, representing the basic diagnostic methods to identify specific causes of impaired metabolism. The author gives special emphasis to the metabolism of micronutrients, i. e. water soluble vitamins (C, Bl, B2, f°lic acid, niacin) and fats (A, D, K) as well as trace elements (Fe, Zn, Cu). Nowadays, when acute starvation is not expected in our area, lack or disbalance of vitamins and minerals is the most frequent cause of impaired nutritive status. Basic biochemical procedures are described to follow-up impaired nutritive status caused by lack or disbalance i the intake of macroelements (Na, K, Ca, Mg, P) and macronutrients in general (proteins, calories, amino acids, N). Modern methods of nutritive status determination, such as total body radioactivity counter, dual X-ray absorptiometry, bioelectrical impedance, classical radiography, computorized axial tomography, nuclear magnetic resonance and ultrasonography have been critically reviewed. Especially the first three of those are very useful to determine the metabolic basis of the nutritive status change both in illness and in health. The paper finally discusses the diagnostic potential of hair analysis to determine the patient's nutritive status as well as to follow-up the results of the recommended nutritive therapy, since it is a non-invasive method and multiple samples are easy to acquire.
Ključne riječi
Hrčak ID:
190466
URI
Datum izdavanja:
1.12.2000.
Posjeta: 2.108 *