Question

A 61-year-old male is admitted to the hospital for resection of his sigmoid colon and rectum, following discovery of a mass in the sigmoid colon by his physician during a flexible sigmoidoscopy. The patient originally complained of bright red blood in his bowel movements. He reported no significant gastrointestinal symptoms other than the bleeding. He denies any change in his functional capacity. His maximum weight was 167 lb (75.9 kg) at age 46 years. In his late 40s, he lost about 15 lb (6.8 kg) and for the past 12 years has maintained his weight at about 152 lb (69.1 kg). Between 2 and 6 months before admission, his appetite was less than normal and he gradually lost 13 lb (5.9 kg). In the past 2 months before admission, his appetite improved and he gained 5 lb (2.3 kg). On physical examination, there is no evidence of subcutaneous tissue loss, muscle wasting, edema, or ascites. Using SGA,How would you rate her nutritional status?

1. SGA case study

2. Submit report (Each topic is 300 words, non-handwriting) about following topics:

Densitometry (Body composition Assessment)

a. Hydrostatic, or underwater weighing.

b. Air Displacement Plethysmography.

c. Neutron Activation Analysis.

d. Total Body Potassium.

Answer 1

1.Subjective global assessment (SGA) evaluates whether an individual is appropriately nourished i.e. whether nutrient intake and absorption meet the nutrient requirements of an individual. When there is an imbalance among nutrient intake, absorption and requirement then malnutrition occurs.

He has poor nutritional status. He is reducing his weight.

2. Densitometry It is based on the assumption that fat has a density constant of 0.9 kg/L, and the fat-free component has a density of 1.1 kg/L. Densitometry measures body mass and volume and calculates body density by using Siri’s equation for Caucasian populations [% fat = 4.95/(D – 4.5) × 100] and Shuttle’s equation for African Americans [% fat = 4.374/(D – 3.928) × 100].

a)hydrostatic or underwater weighing:Hydrostatic weighing, also known as underwater weighing or hydrodensitometry, is one of the most accurate ways to measure body fat.Hydrostatic weighing provides an estimate of total body volume (BV) from the water displaced by the body's volume. According to Archimedes' principle , weight of a body under water is directly proportional to the volume of water displaced by the body's volume. For calculating Db, body mass is divided by body volume.

b)air displacement Plethysmography:With air-displacement plethysmography, the volume of an object is measured indirectly by determining the volume of air it displaces inside an enclosed chamber (plethysmograph). Thus, human body volume is measured when a subject sits inside the chamber and displaces a volume of air equal to his or her body volume.

c)Neutron Activation Analysis:Neutron activation analysis (NAA) is a nuclear process used for determining the concentrations of elements in a vast amount of materials. NAA relies on excitation by neutrons so that the treated sample emits gamma-rays. ... The sample is bombarded with neutrons, causing the elements to form radioactive isotopes.

d)Total Body Potassium:Whole body counting (also called total body counting) measures the amount of naturally radioactive potassium 40 (40K) in the body (total body potassium or TBK). Potassium 40 is a naturally occurring isotope found in a known amount (0.0118%) in intracellular water and is not present in stored triglycerides.