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PubMed2005

Criminally prosecuted cases of child starvation.

OBJECTIVE: Here we describe the clinical findings and legal outcomes in 12 prosecuted cases of infant and child starvation. METHODS: Medical records, investigation records, and transcripts of court testimony were reviewed in the cases of 12 infants and children from locations throughout Texas who had been starved deliberately. The children's ages ranged from 2 months to 13 years. The caretakers of all children received both civil and criminal charges; cases were tried over an 11-year time span. Clinical presentations, examination findings, laboratory findings, symptoms of refeeding syndrome, and legal outcomes were examined. Two illustrative cases are presented in detail here. RESULTS: Of the 12 cases reviewed, the median age was 2.7 years, with a range of 2.25 months to 13 years 7 months. Half of the children died shortly before or soon after presentation for medical care or to law enforcement. Survival was more common in older children than in infants. Most of the children were secluded from others, and all had access to food denied or severely restricted. Caretakers claimed few, benign, or no past medical illnesses in the children. Based on weight and height measurements, 10 of the children had severe wasting and stunting, and 2 had mild or moderate wasting. There was a tendency toward more severe wasting in the fatal cases. All children manifested multiorgan effects of starvation. All survivors manifested complications with refeeding. Approximately half of the children had past or present injuries or history suggestive of physical or sexual abuse. Parental rights were terminated in all cases. A total of 25 individuals were charged criminally; 23 were found guilty or pled guilty, and trials for 2 individuals were pending at the time of this writing. The types of criminal charges and punishment varied from deferred adjudication to a life sentence. CONCLUSIONS: Life-threatening criminal starvation of infants and children is a rare and severe form of child maltreatment. In our series, infants were more wasted at the time of presentation and less likely to survive prolonged starvation than were older children. As with other forms of child abuse, caretakers' histories regarding the children's illnesses were inconsistent with the severity and chronicity of the children's degree of wasting. All victims in our series showed multiorgan effects of chronic malnutrition and deprivation, and all survivors developed refeeding complications and required prolonged periods of recovery.

Adolescent↗

PubMed1982

Effect of starvation and refeeding on the scorpion, Buthus tamulus.

1. Scorpions were starved for 1, 4, 8, and 12 days and then subsequently refed until the sixteenth day. The concentrations of glycogen, amino acid, and protein in the liver were determined to evaluate the effect of starvation and refeeding on these biochemical constituents. 2. The concentration of glycogen decreased gradually but significantly with the progressive days of starvation. After refeeding, the concentration increased sharply and attained the normal condition after 4 days of refeeding. 3. The concentrations of amino acids and proteins increased during first few days of starvation and declined thereafter. After refeeding the concentrations of amino acids and proteins increased gradually and attained the normal conditions after 3 and 4 days respectively. 4. The water content of the liver did not show any significant variation with the progressive days of starvation or after refeeding.

Amino Acids↗

PubMed1999

Mechanism responsible for inactivation of skeletal muscle pyruvate dehydrogenase complex in starvation and diabetes.

Regulation of the activity of the pyruvate dehydrogenase complex in skeletal muscle plays an important role in fuel selection and glucose homeostasis. Activation of the complex promotes disposal of glucose, whereas inactivation conserves substrates for hepatic glucose production. Starvation and diabetes induce a stable increase in pyruvate dehydrogenase kinase activity in skeletal muscle mitochondria that promotes phosphorylation and inactivation of the complex. The present study shows that these metabolic conditions induce a large increase in the expression of PDK4, one of four pyruvate dehydrogenase kinase isoenzymes expressed in mammalian tissues, in the mitochondria of gastrocnemius muscle. Refeeding starved rats and insulin treatment of diabetic rats decreased pyruvate dehydrogenase kinase activity and also reversed the increase in PDK4 protein in gastrocnemius muscle mitochondria. Starvation and diabetes also increased the abundance of PDK4 mRNA in gastrocnemius muscle, and refeeding and insulin treatment again reversed the effects of starvation and diabetes. These findings suggest that an increase in amount of this enzyme contributes to hyperphosphorylation and inactivation of the pyruvate dehydrogenase complex in these metabolic conditions. It was further found that feeding rats WY-14,643, a selective agonist for the peroxisome proliferator-activated receptor-alpha (PPAR-alpha), also induced large increases in pyruvate dehydrogenase kinase activity, PDK4 protein, and PDK4 mRNA in gastrocnemius muscle. Since long-chain fatty acids activate PPAR-alpha endogenously, increased levels of these compounds in starvation and diabetes may signal increased expression of PDK4 in skeletal muscle.

Animals↗

PubMed1984

Effects of 24-hour starvation period on metabolic parameters of 20-day-old rats.

The effects of a 24-hour starvation period upon 20-day-old rat pups were studied both in animals kept in the presence of their starved dams and in their absence. The relative loss of body weight was more intense in the rats that received no milk, being however, severe in both groups. There was a significant maintenance of both plasma glucose levels and total amino acids, with differences in blood glucose compartmentation and a remarkable uniformity in the effects of starvation upon individual amino-acid concentrations. A significant increase in plasma urea was observed, higher in the rats kept in the presence of the dam. Ketone bodies increased with starvation but their final levels were lower than in adults. The general pattern of metabolic change observed suggests a situation, after 24-h food deprivation, similar to that of long term starvation in adults; with an active protein amino-acid catabolism but with a remarkable maintenance of circulating foodstuff levels.

Amino Acids↗

PubMed1986

Effects of starvation on rat liver mRNA translation products.

The synthesis of rat liver protein and RNA decreases with starvation. It is not yet known whether such decreases are regulated strictly at a transcriptional level, or if post-transcriptional controls are also involved. In this study we investigate the effects of 0, 2, or 4 days starvation on the levels of specific, abundant mRNAs in total and polysomal RNA populations. The mRNAs were analyzed by translation in vitro in mRNA-dependent, cell-free, protein synthesizing systems. The resulting polypeptide products were separated by gel electrophoresis and visualized with fluorography. The amount of albumin translated from both polysomal and total cellular mRNA decreased 20-40% with fasting. In contrast, a specific peptide having a molecular mass of approximately 30 kDa increased two- to three-fold in total cellular RNA with a smaller increase observed in polysomal RNA. These changes were maximal at 2 days of starvation. Since starvation is known to cause alterations in liver metabolism the 30-kDa polypeptide may be related to enzymes or other proteins involved in this homeostatic response.

Albumins↗

PubMed1976

The effect of the duration of starvation of the assay bird on true metabolizable energy values.

An experiment was made with adult, S.C.W.L. roosters to measure the effect of the duration of the starvation period, prior to force feeding, on the true metabolizable energy (T.M.E.) value of a laying hen diet. Lengthening the starvation period from 24 to 96 hr., by 24 hr. intervals, had no significant effect on the T.M.E. value. The excretion of metabolic fecal + endogenous urinary energy per day tended to decrease with the duration of starvation. It is therefore, essential that the duration of the starvation period is identical for control and force fed birds. It is also essential that the duration of the experimental period is identical for both groups of birds.

Animals↗

PubMed1984

Effect of starvation-refeeding and an exogenous glucocorticoid on carbohydrate metabolism in chick liver.

Broiler chicks, 4 weeks of age, were subjected to a regimen of 48-hr starvation and 24-hr refeeding as a means of inducing hepatic glycogen supercompensation. A synthetic glucocorticoid (prednisolone) and transcription inhibitor (actinomycin D) treatment were superimposed on the starvation-refeeding regimen to examine the effect of an exogenous glucocorticoid and the necessity for de novo protein synthesis during glycogen supercompensation. Starvation decreased plasma glucose, immunoreactive insulin and liver glycogen. These parameters returned to, or overshot prefasting levels after a 48-hr refeeding period. Prednisolone magnified the overshoot response but some de novo protein synthesis was required. Glycogen synthase a activity was opposite that of liver glycogen content. A possible nonhormone stimulated glycogen synthetic mechanism in the starvation-refeeding response of the chick was noted.

Animals↗

PubMed1970

Carnitine levels in severe infection and starvation: a possible key to the prolonged catabolic state.

Tissue carnitine levels have been measured in man and the dog. Skeletal muscle carnitine levels rise in the dog with starvation to roughly twice the normal level. An equal degree of starvation plus peritonitis is associated with unchanged skeletal muscle carnitine levels. In the presence of peritonitis, sequential skeletal muscle biopsies show a progressive fall in the tissue carnitine levels with a subsequent rise in those animals which survive and clear their peritonitis. Normal human skeletal muscle levels are essentially the same as in the dog. A combination of sepsis and starvation in man is associated with essentially unchanged skeletal muscle carnitine levels, whereas pure sepsis without starvation is associated with decreased skeletal muscle carnitine levels. It is suggested that these changes are in the direction expected for a limitation of fat catabolism and, in the presence of a limited exogenous source of glucose, that this would result secondarily in a protein catabolic state to supply glucose for the body's energy needs.

Animals↗

PubMed1975

The effect of starvation and refeeding on cell population kinetics in the rat small bowel mucosa.

Male rats were starved for a period of 96 hours. Measurements of crypt cell population showed a small reduction during starvation. The growth fraction remained constant, but the total number of proliferating cells per crypt fell as a consequence of the reduction in crypt population. Both labelling and mitotic indices fell throughout the starvation period. The cell cycle time (Tc), measured by a stathmokinetic technique using vincristine, was increased from 10-4 hours in control rats to 14-7 hours after 96 hours' starvation. Upon refeeding, the proliferative indices were observed to rise. After a small initial fluctuation, the growth fraction remained constant. The crypt population remained substantially unchanged. Sixteen hours after refeeding, the cell cycle time was reduced to 6-5 hours. The hypoproliferative response to starvation is mediated solely by an increase in cell cycle time, and the response to refeeding is interpreted in terms of a reduction in Tc. Changes in the size of the proliferating population are considered not to play an important role in either response, although it is not possible to exclude entirely the presence of resting cells in the proliferative compartment itself.

Animals↗

PubMed1976

Influence of age and starvation on pO2, pCO2 and haematocrit values in the rat.

The author determined the effect of acute starvation on the arterial pO2 and pCO2 value (analysed on a micro-Astrup apparatus) in rats of different ages; in infant rats, this was done by separating them from the female and the nest for 24 hours. Arterial blood was obtained by incising the tail artery. It was found that the pO2 value in rat arterial blood rose signficantly during ontogenesis. At 10 and 14 days the mean pO2 value was 68 torr, while at 25 days and in adult rats it was 92-95 torr. No marked changes were found in CO2 during ontogenesis (the mild drop was not statistically significant). In 10- and 14-day-old rats, 24 hours' starvation caused a significant decrease in pO2. In older rats, deprivation of food and water did not significantly affect the pO2; in the arterial blood. The arterial blood pCO2 was not influenced by starvation. The development of the haematocrit values in mixed blood (obtained by decapitation) during ontogenesis was in agreement with findings in the literature, i.e. a drors' complete starvation produced no change in the haematocrit values in 5- and 10-day-old rats, but a marked increase was recorded in older rats.

Aging↗

PubMed2003

Diabetes- and semi-starvation-induced changes in metabolism and regulation of Na,K-ATPase in rat heart.

AIMS/HYPOTHESIS: In comparison with healthy controls, rats with streptozotocin-induced diabetes exhibit retarded gain in body weight. This is generally attributed to lowered protein synthesis resulting from abnormal metabolism. Furthermore, decreased abundance and activity of Na,K-ATPase in heart and skeletal muscle has been described. However, decreased gain in body weight per se is accompanied by a down-regulation of skeletal muscle Na,K-ATPase. Thus, the aim of the present study was to evaluate cardiac Na,K-ATPase in semi-starvation and diabetes. METHODS: Diabetes was induced in male Wistar rats with streptozotocin. In healthy parallel running control rats body weight gain was kept reduced by limited food intake. RESULTS: Semi-starved and diabetic rats demonstrated 18 and 16% (p < 0.05) retarded gain in body weight after 63 days. As compared to semi-starved rats, diabetic animals exhibited a 59-273% (p < 0.05) increase in glucose, glycohaemoglobin, triglyceride and cholesterol plasma levels. Activity of heart K-pNPPase, reflecting Na,K-ATPase, in crude membrane homogenates was reduced by 29 and 10% (p < 0.05) by diabetes and semi-starvation. The age-dependent reduction in heart K-pNPPase in normal controls was 6%. After subtracting the age-dependent change, the reductions were 25 and 4% in diabetes and semi-starvation, respectively. After subtracting the semi-starvation-associated change, the diabetes-induced reduction was 22-27%. The reduction was in accord with measurements of Na,K-ATPase activities in partially purified membranes, Na,K-ATPase isoforms and cytochemical evaluations. Expressed per heart, the reduction in Na,K-ATPase was 30%. CONCLUSIONS/INTERPRETATION: Streptozotocin-induced diabetes selectively reduces heart Na,K-ATPase concentration by around 1/4, which reduces the capacity of the heart for maintaining K- and Ca-homeostasis. This may pose a risk of arrhythmias and may be associated with heart failure in diabetic cardiomyopathy.

Animals↗

PubMed1975

Effects of glucose starvation on normal and rous sarcoma virus-transformed chick cells.

We studied the effect of glucose starvation on glucose uptake and thymidine uptake and incorporation in cultures of normal chicken embryo cells and those transformed by Rous sarcoma virus. Resting normal fibroblasts increased the rate of glucose transport up to tenfold when they were starved for glucose, whereas fast-growing normal cells doubled the rate of uptake after starvation. Transformed cells did not show any change in the rate of glucose uptake during starvation. Thymidine uptake and incorporation by normal and transformed cells were not affected by glucose starvation. These results showed that a decrease in the glucose concentration of the medium induced a specific increase in the rate of glucose transport by normal chick fibroblasts, but did not change the transport of glucose by transformed cells. Therefore, it is suggested that glucose or one of its metabolic products regulated the hexose uptake of normal chick fibroblasts. Virus-transformed cells were insensitive to this regulation.

Animals↗

PubMedDate not supplied

[Glutathione defense system in various brain structures during starvation].

Distribution of glutathione reductase (GR) and selenium-dependent glutathione peroxidase (GP) activity and the content of selenium in the cytosolic fraction of the brain stem, hypothalamus and different cortical areas of the rat cerebrum in norm and under starvation was investigated. It was shown that GR activity in all investigated structures was approximately identical, but GP activity in various cortical areas was 1.5-2.0 times higher, than that in the mesencephalon and myeloencepalon. During 2-3 days of starvation GR activity changed insignificantly, whereas GP activity varied within wide limits. Under prolonged starvation a significant decrease in the content of selenium and GP activity was observed. The correlation of these changes was more expressed in the hypothalamus. It was assumed that glutathione and enzymes of its metabolism were involved in the regulatory system of redox processes in the nervous tissues in the primary period of starvation.

Animals↗

PubMed1979

[Effects of different growth rates in weaned piglets, starvation and hormonal action, on various metabolic parameters in the blood plasma].

Changes in concentrations of metabolites of the main nutrients in the blood plasma, caused by weaning and by different body weight gains, by starvation, exogenous adrenaline and ASTH administration were studied in 141 weaned piglets of the Large White breed at an age of 26 to 69 days. After weaning, the total protein level showed a faster decrease in the intensively growing piglets than in those with lower growth rates. This rapid decrease was induced by adrenaline. The post-weaning levels of glucose decreased irrespective of the growth rate of the piglets. Adrenaline caused hyperglycaemia and, after 48 hours of starvation, hypoglycaemia. Urea levels significantly increased after weaning. During starvation they remained unchanged, even under exposure to hormonal effects. Cholesterol concentration decreased after weaning, after ACTH and adrenaline administration also showed a decrease. The concentration of non-esterified fatty acids decreased after weaning, the decrease being more pronounced in the piglets with less intensive growth. The action of adrenaline, ACTH, together with an increased level of glucocorticoids, increased the concentration of these acids even in the state of starvation. It is assumed that early piglet weaning implies great metabolic changes which need not impair growth if their character is transient. The author evaluates the suitability of the starter used and parameters chosen for the determination of the metabolic profile of pigs.

Adrenocorticotropic Hormone↗

PubMed1979

Effect of starvation on tissue and serum gluconeogenic enzymes, alkaline phosphatase and tissue glycogen in the freshwater catfish, Heteropneustes fossilis (Bloch).

The influence of starvation has been studied on tissue and serum G-6Pase F-D-Pase and alkaline phosphatase activities and on the muscle and liver glycogen content of the freshwater catfish H. fossilis (Bloch). A marked increase in G-6Pase and F-D-Pase activities and a fall in the muscle and liver glycogen content recorded during 40 day starvation. The rise in gluconeogenic enzymes during starvation may be due to glucocorticoid stimulation. Alkaline phosphatase activity was found to decline markedly during starvation. The decline in enzyme activity is attributed to some factors like a fall in the rate of synthesis caused by lowered metabolic demands and to electrolyte imbalance caused by tissue overhydration. The fall in glycogen content may be related to the starved condition of the fish. Elevation in glycogen content and alkaline phosphatase activity and a fall in gluconeogenic enzymes were noted when feeding had been resumed.

Alkaline Phosphatase↗

PubMed1988

Protein and energy metabolism in starvation reconsidered.

Current concepts of the metabolic changes during starvation have been heavily influenced by recent studies on grossly obese subjects undergoing therapeutic fasting. It has been suggested that during prolonged starvation the central nervous system develops the ability to utilize ketone bodies, and that the consequent reduction in gluconeogenesis leads to an adaptive sparing of protein catabolism. However, our analysis of classical studies on starvation shows that during prolonged starvation in normal subjects the fraction of total energy expenditure derived from protein (the P ratio) remained unchanged. Although urinary nitrogen was reduced during the progress of the fast, we conclude that this is secondary to the general reduction in metabolic rate, rather than to a specific sparing of protein.

Energy Metabolism↗

PubMed1988

Morphological changes and catalase activity in the hearts of CD 1 mice following acute starvation or single doses of doxorubicin, epirubicin or mitoxantrone.

The cardiac morphology of CD 1 mice undergoing two different schedules of acute (5 day) starvation and that of animals treated with a single dose (15 mg/kg i.p.) of doxorubicin, epirubicin or mitoxantrone were studied by light microscopy. Determinations of heart catalase were also carried out. Mice subjected to moderate starvation had a mean weight reduction of 18.7% and did not show heart morphological damage. A slight increase (38%) of heart catalase specific activity occurred in these animals. In animals subjected to severe starvation the weight loss was 32.2%. In this case considerable heart damage, in the form of myofibrillar loss, and a striking increase of catalase (158.5%) were seen. In the drug groups comparable weight reductions (about 15%) occurred 5 days after the treatment. Moderate heart lesions, represented by myolysis and especially by myocytic microvacuolation, were observed and appeared to be of similar degree in the 3 drug groups. Catalase specific activity increased by 119.9% in the doxorubicin animals, by 73% in the epirubicin mice and by 30.3% in the mitoxantrone ones. Light microscopy made it possible to distinguish between cardiac alterations induced by starvation and those specifically induced by antiblastics. Catalase may be helpful to indicate the existence of heart damage but it does not correlate well with the severity of the lesions by antiblastics. An additional cause of heart catalase elevation might be the free radical generation induced by the anthracyclines but not by mitoxantrone.

Animals↗

PubMedDate not supplied

[The effect of starvation on GABA-transaminase and glutamate decarboxylase activity on mitochondria of dog limbic structures during postnatal ontogenesis].

Activities of GABA-transaminase (GABA-TA) and glutamate decarboxylase (GDC) were estimated in mitochondria of limbic cortex (L1 and L2 areas), hypothalamus, hippocampus, amygdala and midbrain reticular formation (RF) of 3 months and 1 year old dogs during 5, 12 and 20 days of starvation. Total activity of GABA-TA and GDC was distinctly decreased in mitochondria of limbic cortex, hippocampus, hypothalamus and amygdala. At the same time, after 5 days starvation activity of GDC, in presence of 0.1 mM PALP or without it was increased in RF mitochondria of 3 months old dogs, while GABA-TA was activated in the mitochondria of 1 year old dogs. The rate of GDC activation by PALP was dissimilar in certain structures of brain limbic areas during various periods of starvation in 3 months old dogs, which occurred due to difference of the GDC mitochondrial forms in synaptic structures of the dog brain limbic system. Activity of GABA-TA in 3 months and 1 year old dogs as well as activity of GDC, in presence of PALP or without it, in 3 months old dogs were distinctly decreased in mitochondria of all the dog brain limbic structures studied after long-term deprivation within 12 and 20 days. The decrease in activity of GABA-TA and GDC was related to duration of starvation as well as to morpho-functional alterations and adaptation of the brain structures studied during postnatal ontogenesis.

4-Aminobutyrate Transaminase↗