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Among the preterm infant or the newborn with a chronic disease, feeding disorders are described in 40 to 70% of cases, even an overwhelming 90% for the very preterm. The prolonged artificial ventilation could delay the oral feeding autonomy of the newborn.The aim of our study is to tell exactly the present incidence for the first year of life, of feeding difficulties among the preterm infant or suffering of a congenital malformation in a neonatal unit "N" where the prevention strategies for feeding disorders have been adopted since 2010.METHODS : The prospective cohort study was run in the Neonatal Intensive Care Unit at Cliniques Universitaires Saint-Luc starting from the 31/01/2011 until the 31/07/2012 . Ali the newborns were barn at the Hospital and had to stay at least 15 days in the unit. Three groups of newborns have been formed : the group A included the preterm infants from 34 to 36 weeks of gestational age ; the group B, the preterm infants of 32 weeks and least of gestational age ; the group C, the newborns with a congenital disorder. The newborns included in the study had been followed until the adjusted age of 12 months at best, the check points having been fixed at 4, 8 and 12 months.The following clinical data had been listed: gestational age, sex, Apgar score, biometric data, possible resuscitation maneuvers, technique and length of ventilation, technique and length of artificial feeding, age of acquired oral feeding autonomy, length of stay, age when they returned home, feeding regime and treatment when discharged. Then, questionnaires about feeding type, the length of meal, the feeding behavior during the meal, a possible selective .... Had been filled by the parents (through internet or during the consultations CAP48) when the child reached the adjusted age of 4 months, 8 months and 12 months.RESULTS : 175 newborns have been included and divided into 3 groups : 51 in the group A, 105 in the group B and 19 in the group C. The incidences of feeding disorders are respectively of 0%, 5,1% and 10,5%.CONCLUSIONS : The strategies of preventive cares established in the neonatal intensive care unit largely explain the overall low incidence of feeding disorders in our study. However, it's more important among the newborns with a congenital malformation and among the very preterm infant (< 32 SA) while it's absent among the preterm infant from 34 to 36 weeks of amenorrhea. Chez le prématuré ou le nouveau-né atteint de pathologie chronique, des troubles alimentaires sont décrits dans 40 à 70% des cas, voire 90% chez le grand prématuré. La ventilation artificielle prolongée retarderait l'autonomie alimentaire orale du nouveau-né. Le but de notre étude est de préciser l'incidence actuelle durant la première année de vie, de difficultés alimentaires chez le nouveau-né prématuré ou atteint de malformation congénitale dans un service de néonatalogie « N » où des stratégies préventives des troubles alimentaires sont adoptées depuis 2010 .METHODOLOGIE : L'étude a été menée de manière prospectivedans le Service de Néonatalogie des Cliniques Universitaires Saint-Luc durant la période du 31/01/2011 au 31/07/2012. Les nouveau-nés inclus étaient tous nés aux Cliniques et devaient avoir séjourné au minimum 15 jours dans le service. Trois groupes de nouveau-nés ont été constitués : le groupe A comprenait tous les prématurés de 34 à 36 semaines d'âge gestationnel ; le groupe B, les prématurés de 32 semaines ou moins d'âge gestationnel ; le groupe C, les nouveau-nés atteints de malformation congénitale. Les nouveau-nés inclus dans l'étude ont été suivis jusqu'au 12ème mois maximum d'âge corrigé, les points d'évaluation ayant été fixés à 4, 8 et 12 mois. Les données cliniques suivantes ont été répertoriées: âge gestationnel, sexe, score d'Apgar, données biométriques, manœuvres de réanimation éventuelle, technique et durée de ventilation, technique et durée d'alimentation artificielle, âge d'acquisition de l'autonomie alimentaire orale, durée du séjour, âge de retour à domicile, régime alimentaire et traitement à la sortie du service. Ensuite, des questionnaires portant sur le type d'alimentation, la durée des repas, le comportement lors des repas, une éventuelle sélectivité alimentaire ont été remplis par les parents (par internet ou lors des consultations CAP48) quand l'enfant atteignait l'âge de 4 mois, 8 mois et 12 mois d'âge corrigé.RESULTATS : 175 nouveau-nés ont été enrôlés et répartis en 3 groupes : 51 dans le groupe A, 105 dans le groupe B et 19 dans le groupe C. Les incidences de troubles alimentaires sont respectivement de 0%, 5,1% et 10,5%.CONCLUSIONS : Les stratégies de soins préventives mises en œuvre dans le Service de Néonatalogie expliquent en grande partie la faible incidence générale des troubles alimentaires dans notre étude. Elle reste néanmoins plus présente chez le nouveau-né atteint de malformation congénitale et chez le grand prématuré (< 32 SA) alors qu'elle est inexistante chez le prématuré de 34 à 36 SA.
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Quatrième de couverture : "Notre société a peur de vieillir et de mourir. Elle a aussi terriblement peur de grossir. Confrontées à une situation de disponibilité et de pléthore jamais connue, de nombreuses jeunes femmes se soumettent à une alimentation contrôlée et restreinte. Ce comportement conduit à des troubles alimentaires, anorexies et boulimies notamment, avec leur cortège de désordres physiques et mentaux sévères.Primitive ou secondaire, la peur de grossir se trouve au cœur de la plupart des troubles alimentaires. Cette peur entretient et aggrave ces troubles. Il faut donc intervenir pour rompre le cercle vicieux : restriction-anorexie-boulimie, désordres psychologiques. Liés à des causes multiples, ces troubles alimentaires ne peuvent être abordés sous un seul angle. Seule une approche multidisciplinaire permet de pacifier la relation à l’aliment et au corps. À travers l’analyse minutieuse de tous les facteurs en cause, Bernard Waysfeld envisage les différentes prises en charge et privilégie l’approche de la personne dans sa singularité. Car réduire le trouble alimentaire à un simple trouble des conduites ou pire à un trouble nutritionnel constitue une démarche contre-productive vouée à l’échec."
Eating disorders --- Comportement alimentaire, Troubles du --- Nutrition Disorders --- Eating Disorders
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Malnutrition. --- Diet in disease. --- Diet and disease --- Disease, Diet in --- Sick --- Dietetics --- Nutrition disorders --- Nutrition --- Starvation
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This report presents the results of a conference of 38 national experts in nutrition and public health who met to develop performance standards that could guide restaurants toward facilitating healthier choices among consumers and that local communities or states could use as a model for developing and implementing either voluntary or mandatory certification programs.
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Obesity --- Obesity. --- Adiposity --- Corpulence --- Fatness --- Overweight --- Body weight --- Metabolism --- Nutrition disorders --- Disorders --- Obesity Management --- Body Weight --- Hyperphagia --- Weight Gain --- Bariatrics --- Metabolic & Nutritional Diseases
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Georges Vigarello maps the evolution of Western ideas about fat and fat people from the Middle Ages to the present, paying particular attention to the role of science, fashion, fitness crazes, and public health campaigns in shaping these views. While hefty bodies were once a sign of power, today those who struggle to lose weight are considered poor in character and weak in mind. Vigarello traces the eventual equation of fatness with infirmity and the way we have come to define ourselves and others in terms of body type. Vigarello begins with the medieval artists and intellectuals who treated heavy bodies as symbols of force and prosperity. He then follows the shift during the Renaissance and early modern period to courtly, medical, and religious codes that increasingly favored moderation and discouraged excess. Scientific advances in the eighteenth century also brought greater knowledge of food and the body's processes, recasting fatness as the "relaxed" antithesis of health. The body-as-mechanism metaphor intensified in the early nineteenth century, with the chemistry revolution and heightened attention to food-as-fuel, which turned the body into a kind of furnace or engine. During this period, social attitudes toward fat became conflicted, with the bourgeois male belly operating as a sign of prestige but also as a symbol of greed and exploitation, while the overweight female was admired only if she was working class. Vigarello concludes with the fitness and body-conscious movements of the twentieth century and the proliferation of personal confessions about obesity, which tied fat more closely to notions of personality, politics, taste, and class.
Body weight --- Obesity --- Adiposity --- Corpulence --- Fatness --- Overweight --- Metabolism --- Nutrition disorders --- Anthropometry --- Body size --- Weights and measures --- Body composition --- Weight gain --- Weight loss --- Social aspects --- History. --- Disorders
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Obesity in children. --- Children --- Child nutrition --- Pediatric nutrition --- Pediatric nutritionists --- Childhood obesity --- Corpulence in children --- Metabolic disorders in children --- Nutrition disorders in children --- Nutrition. --- Food
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Adipose tissues --- Obesity --- Physiology. --- Pathophysiology. --- Adiposity --- Corpulence --- Fatness --- Overweight --- Body weight --- Metabolism --- Nutrition disorders --- Adipose tissue --- Body fat tissues --- Fat tissue --- Fatty tissue --- Connective tissues --- Fat --- Disorders
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Obesity -- Exercise therapy. --- Obesity --- Musculoskeletal Physiological Processes --- Overnutrition --- Nutrition Disorders --- Musculoskeletal Physiological Phenomena --- Nutritional and Metabolic Diseases --- Musculoskeletal and Neural Physiological Phenomena --- Diseases --- Phenomena and Processes --- Exercise --- Medicine --- Health & Biological Sciences --- Metabolic & Nutritional Diseases --- Exercise therapy --- Exercise therapy. --- Adiposity --- Corpulence --- Fatness --- Overweight --- Body weight --- Metabolism --- Nutrition disorders --- Disorders
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The worldwide prevalence of obesity has increased dramatically in recent years. Since the results of long-term dietary behavioral therapy remain sadly inadequate, surgery is currently the only effective treatment for patients with severe or morbid obesity. The numbers of weight loss operations continue to increase annually throughout the world. The anesthetic management of severely obese patients entails special challenges, especially when medical co-morbidities are present. Published outcome data on anesthetic care and pain management of these patients are scarce, and many practices remain controversial. Controversies in the Anesthetic Management of Obese Patients considers a wide range of important practical issues. Key questions in preoperative, intraoperative, and postoperative management are addressed, and different approaches are evaluated. Written by international leaders in the field, this book will be an invaluable aid for anesthesia care providers.
Anesthesia --- Obesity --- Anesthesiology. --- Complications. --- Anaesthesiology --- Surgery --- Adiposity --- Corpulence --- Fatness --- Overweight --- Body weight --- Metabolism --- Nutrition disorders --- Complications and sequelae --- Disorders --- Obesity, Morbid --- Perioperative Care. --- Complications --- methods. --- complications. --- Emergency medicine. --- Emergency Medicine. --- Medicine, Emergency --- Medicine --- Critical care medicine --- Disaster medicine --- Medical emergencies
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