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PubMedDate not supplied

Metabolic problems after gastric surgery.

The findings on dumping syndrome (DS) are not consistent considering its relations with age, sex, weight/height, smoking habits, race, dose of oral glucose, the time elapsed since surgery, the function of exocrine pancreas nor the duration of ulcer symptoms. The patients after total gastrectomy (TG) may present relative postprandial lack of insulin. As a sign of long-term hyperglycemia elevated HbA1 has been measured in DS patients. Oral galactose test may reveal new features of DS. Abnormalities in splanchnic blood circulation as well as release of intestinal hormones are involved with DS. Dietary habits including fibers, pectin and guar gum, play a central role in the prevention and treatment of DS. In unresponsive cases several operative methods have been applied with success. Alkaline reflux gastritis is most often seen after B II and I reconstructions and after pyloroplasty. Chronic diarrhea follows mostly after truncal vagotomy. Ten to 50% of patients after gastrectomy (GE) waste 10 to 20% of their body weight because of decreased food, energy, vitamin and mineral intake caused by eating-related symptoms. Vitamin and mineral supplements, a small snack 20 min before the major meal, digestive enzymes, treatment of colonization with antibiotics and protein foods may help. About 50% of GE patients show iron deficiency anemia. Easily dissolved iron between meals with ascorbic acid give the most effective response. Deficiency of vitamin B12 or of folate may develop as megaloblastic anemia. B12 supplement and antibiotics are effective in bacterial overgrowth, but surgical correction is necessary in troublesome blind loop. Folic acid deficiency is corrected by oral folic acid.(ABSTRACT TRUNCATED AT 250 WORDS)

Dumping Syndrome↗
PubMed1977

[Applied neurochemistry (author's transl)].

Metabolic disorders may also be accompanied by neurological symptoms. Diagnosis is ofter difficult because clinical opportunities are rare. But some things can be detected even by simple means. In particular, primary biochemical disturbances are discussed, insofar as they may have an unfavorable effect on the nervous system. Among these are hypoglycemia, hyperglycemia, cerebral nutritional disorders, phenylketonuria. Wilson's disease, folic acid deficiency and acute intermittent porphyria.

Amines↗
PubMed1988

Serum folate levels in normal full-term pregnant Chinese women.

Serum folate levels were determined by a radio-isotopic assay method and then analysed in 253 normal full-term pregnant women. None of them had received any hematonic during their whole pregnancy period. Their mean age was 27.72 years and the mean pregnancy duration was 39.50 weeks. Mean hemoglobin concentration in these normally pregnant women was 12.54 g%. Mean serum folate was 8.57 ng/ml. In this study, 7.51% (19 out of the 253) of the normally pregnant women had a folate level less than 3 ng/ml, and only 2 of them had clinical anemia (Hb less than 11 g%), and one of them also had serum ferritin less than 12 ng/ml. Thus pure folic acid deficiency anemia in pregnant women may be very rare in Chinese. Neither multiparity, age, nor gravida number played any role in the occurrence of folate deficiency. There would appear to be a slight positive relationship between folate levels and hemoglobin concentration in pregnant Chinese women.

Adult↗
PubMed2005

Folate deficiency inhibits proliferation of adult hippocampal progenitors.

Neurogenesis in the adult hippocampus may play important roles in learning and memory, and in recovery from injury. As recent findings suggest, the perturbance of homocysteine/folate or one-carbon metabolism can adversely affect both the developing and the adult brain, and increase the risk of neural tube defects and Alzheimer's disease. We report that dietary folic acid deficiency dramatically increased blood homocysteine levels and significantly reduced the number of proliferating cells in the dentate gyrus of the hippocampus in adult mice. In vitro, the perturbance of one-carbon metabolism repressed proliferation of cultured embryonic multipotent neuroepithelial progenitor cells and affected cell cycle distribution. Our results suggest that dietary folate deficiency inhibits proliferation of neuronal progenitor cells in the adult brain and thereby affects neurogenesis.

Animals↗
PubMed1977

[Folic acid substitution in advanced renal disease (author's transl)].

The plasma content of folic acid was evaluated in 27 patients with advanced renal disease. There were no significant morphologic changes within the erythrocyts of the peripheral blood and bone marrow. The hematologic response of the reticulocyts, hemoglobin and hematokrit were studied after oral treatment with folic acid. There was a significant reticulocytosis at the 5th to the 8th day after initiating the oral treatment. This reaction underlines a definite, mainly nutritional (latent) folic acid deficiency being one cause for the renal anemia in these patients. A subsequent rise of the hemoglobin or hematocrit did not occur. Further possible causes for these clinical data are being discussed.

Adult↗
PubMed1979

Anaemia in twin pregnancy.

A total of 123 twin pregnancies were studied, 68 by records analysis only, and 55 by serial haematological assessment in detail. The incidence of low haemoglobin levels is found to be greater than in singleton pregnancy; evidence of iron and folic acid deficiency is common in sternal marrow aspirates but not in peripheral blood films. Routine haematinic prophylaxis in twin pregnancy is not advocated.

Anemia↗
PubMed2005

[Pancytopenia, haemolytic anaemia, schistocytes: a frequent pathology mimicking a rare and serious pathology].

A 83 years old woman presents to our hospital with fatigue and dyspnea since 2 weeks, followed by a painless icterus. On laboratory we discover a pancytopenia with severe haemolytic anaemia, thrombopenia and schistocytosis. This association suggest a thrombotic microangiopathy. In the presence of macrocytes, hypersegmented neutrophils and a low reticulocytes count, a vitamin screening was performed witch leads to the discovery of a vitamin B12 and folic acid deficiency. After initiation of a vitamin therapy we observe a reticulocytic crisis and thereafter the normalisation of the haematological parameters.

Aged↗
PubMed1982

Acute toxicity of methanol in the folate-deficient acatalasemic mouse.

Formate acidosis is the chief measurable biochemical characteristic of acute methanol toxicity in man. Its marked elevation in the blood stream of primates has been proposed to account for their much greater susceptibility versus rodents to methanol poisoning. Therefore, a study was undertaken to assess whether folic acid deficient (FAD) mice which accumulate formate are much more sensitive to the lethal effects of this alcohol than folic acid sufficient (FAS) mice. Moreover, because some formate is oxidized by catalase-H2O2 in rodents, but not in primates, we also compared the urinary excretion and blood plasma accumulation of formate and the methanol sensitivity of acatalasemic mice. Methanol-dosed C57BL/6Csb (acatalasemic) mice exhibit slightly lower LD50S than CSa (normal catalase) mice, irrespective of their folate state. CSb-FAD mice excreted much more formate and developed higher plasma formate concentrations (11-17 mM) than identically dosed CSa-FAD animals (6 mM). However, in no instance did a folate deficiency produce a large reciprocal decrease in the oral or i.p. LD50 that would be expected from a huge increase (greater than 10-fold) in the 24-h blood plasma formate level. A low methionine (0.2%) intake did not decrease the oral methanol LD50 of CSb-FAD mice, although excess dietary methionine (1.8%) did lower it from 7.1 to 6.4 g/kg. Methanol treated (4 g/kg) Csb-FAD mice excreted 30.8-48.2% of the oral dose as urinary formate, depending on the level of dietary methionine. Csb-FAS and -FAD mice which were given 2 g/kg sodium formate orally (LD50 = 4.7 and 3.7 g/kg) cleared this dose from the blood within 24 h and excreted 58% and 76% of it, respectively, in the urine. Our results indicate that the plasma formate concentration does not correlate well with methanol lethality in Csb-FAS vs. -FAD mice. In addition, urinary excretion, not oxidation, is the primary means by which mice, and probably rats, eliminate high levels of blood formate. Since the Csb-FAD mouse attains high plasma formate levels and low blood pH-values similar to those which have been reported for methanol poisoned monkeys, it appears to be of value as an inexpensive small animal model for further studies of lethal methanol toxicity and the contribution of formate to this process.

Acatalasia↗
PubMed1984

Nonrandom distribution of methotrexate-induced aberrations on human chromosomes. Detection of further folic acid sensitive fragile sites.

Eleven folic acid sensitive fragile sites (3p14, 7p13, 7q31.1, 7q32, 9q32, 11p13, 14q23, 15q22, 16q23, Xp22.2, Xq22) were detected in one individual, eight of them previously unknown. These sites seem to bear each its specific sensitivity to folic acid deficiency. Six of the sites were observed simultaneously on both homologous chromosomes in at least one cell. Each of these 11 sites was also found in at least one among 12 individuals further examined. Some of these individuals showed six of these 11 sites. The fragile site 3p14 was detected in all individuals examined. The homologous sites 3p14 of one individual differed from each other in their frequency of lesions induced by methotrexate as well as fluorodeoxyuridine. This observation suggests that folic acid sensitivity is a property inherent in the chromatin of an individual chromosome at the site involved in fragility. This property seems to be responsible for the nonrandom fragility at that site and also for the individual sensitivity of each chromosomal site.

Cells, Cultured↗
PubMed1993

Vitamin B12, folic acid and haematological status in elderly Thais.

Serum vitamin B12, folic acid and haematological data from 147 elderly people (55 males and 92 females) who visited the special clinic for the elderly at Rajvithi Hospital, Bangkok between July and November 1989 were investigated. The individuals studied came from a health-conscious group of the middle socio-economic class in Bangkok. All of them were fairly well except for minor ailments and typical diseases of elderly people such as hypertension, mild to moderate degree coronary heart diseases and non-insulin dependent diabetes mellitus. There was a statistically significant difference in haemoglobin concentrations between males and females. According to the standard haemoglobin cut-off point values of 13 g/dl for males and 12 g/dl for females, anaemia was detected in 22 (15%) of the 147 subjects. The percentage of folic acid deficiency was found to be 20.6 per cent (30 of the 147 cases). Vitamin B12 insufficiency was found in only 6.9 per cent (10 of the 147 cases). No statistically significant correlation between haemoglobin, folic acid and vitamin B12 was found. However, when the data were grouped according to different intervals of increasing haemoglobin concentrations, for females there was a tendency for serum vitamin B12 to decrease, and serum folic acid to increase in both males and females. The results of this study suggest that folate deficiency may play a role in the occurrence of anaemia in elderly people, and therefore, dietary counselling and supplementation of folic acid are recommended.

Aged↗
PubMed1982

Diminished serum folic acid levels in renal transplant recipients.

Serum folic acid levels were determined by radioimmunoassay in 26 chronic hemodialysis patients, in 52 renal transplant recipients and in 20 healthy controls. In the dialyzed patients, the mean serum folic acid level was 3.37 +/- 1.25 ng/ml and was significantly lower than that of the controls (6.1 +/- 1.38 ng/ml, P less than 0.001). In renal transplant recipients the mean folic acid concentration was 4.09 +/- 1.58 ng/ml and was also significantly decreased (P less than 0.001). 15 (29 per cent) out of 52 renal transplant patients showed serum folic acid concentrations lower than 3.0 ng/ml. Diminished serum folic acid levels were found not only in patients shortly after surgery but also in cases with excellent graft function up to 6 years after transplantation. The highest serum folic acid level was observed in one transplant patient who had taken no azathioprine for 24 months. Macrocytosis was found in 52 per cent of our renal transplant patients. There was no significant difference between the serum folic acid levels of renal transplant recipients with (n = 27) and without (n = 25) macrocytosis; however, serum creatinine levels were significantly lower in cases revealing macrocytosis. Relative folic acid deficiency does not seem to be responsible for macrocytosis after renal transplantation. Macrocytosis was observed only in patients with good graft function treated with azathioprine. Serum vitamin B12 levels were within the normal range in both dialyzed and renal transplant patients.

Adolescent↗
PubMed1977

Anemia in the elderly patients with special reference to folic acid status.

To investigate the role of folic acid deficiency in the pathogenesis of anemia in the elderly, hematological examinationa and assays of serum iron, vitamin B12 and folate were carried out on the 86 elderly patients admitted to a home for the aged. Means of red blood cell counts, hemoglobin levels and hematocrit were 385.3 x 10(4)/mm3, 12g/dl and 36%, respectively. These levels were lower than any other report in Japan. Anemia was detected in 23 out of 86 patients. Judging from mean corposcular volume and mean corposcular hemoglobin, most of them were normocytic and normochromic. Although low serum levels of iron and folate were rather frequently observed, the results on hematological examinations suggest that deficiency of these factors alone is not the cause of the anemia in the elderly patients. Rapid clearance of 5-methyl-tetrahydrofolic acid and increased excretion of formiminoglutamic acid after histidine loading were revealed in some of those who had subnormal serum folate levels. Therefore, supplementation of folic acid is recommended to those who had poor dietary intake.

Aged↗
PubMed1994

Folic acid in neurodevelopment and child psychiatry.

1. Folic acid deficiency has been associated with diverse neuropsychiatric symptoms. 2. This paper discusses the impact of folate on brain development, maturation and function and reviews the role of folate in psychiatric disorders, particularly childhood disorders. 3. A brief case report examines the use of folate in the treatment of attentional problems in a child with fragile X syndrome.

Brain↗
PubMed1999

Megaloblastic marrow in macrocytic anaemias at Kenyatta National and M P Shah Hospitals, Nairobi.

OBJECTIVE: To determine the diagnostic value of megaloblastic marrow in patients with possible vitamin B12 and/or folate deficiency and to look for criteria that could be used in diagnosis of vitamin B12 deficiency. DESIGN: Prospective study. SETTING: Kenyatta National Hospital and M P Shah Hospital, Nairobi. SUBJECTS: Patients of all age groups and both sexes presenting with clinical and blood picture of macrocytic anaemia. MAIN OUTCOME MEASURES: Response to vitamin B12 injections. Vitamin B12 deficiency diagnosed by the following methods: Vitamin B12 serum level assays alone, bone marrow examination alone and both vitamin B12 assays and bone marrow examination. Response was measured clinically and by increase in haemoglobin level after three weeks of treatment. RESULTS: Three hundred and forty-three patients were evaluated; 156 (45.5%) were males, and 187 (54.5%) females. Age range was 13-80 years and a mean of 37.7 years. Initial investigations were as follows: 21.9% had vitamin B12 assays only, 59.2% bone marrow examination only and 19.9% both vitamin B12 assayed and bone marrow evaluated. Haemoglobin increase after a total of 6,000 mcg of vitamin B12 was between 2.6-4.6 g/dl in three weeks. Reticulocytes measured on day ten ranged between 12% and 17%. Uniform improvement in all patients was observed for white blood cells (WBC) and platelet counts. Other significant results and observations included clinical improvement in the signs and symptoms of anaemia after the 6,000 mcg injection of vitamin B12 given over three weeks. Serum folic acid level was determined in 21% of cases and in all these it was normal. CONCLUSION: The important practical points were response to vitamin B12 in all cases and the importance of re-assessing patients after a total of 6,000 mcg of vitamin B12. Folic acid deficiency was not detected. Patients in these two institutions with megaloblastic anaemia had vitamin B12 deficiency. It is proposed that a model consisting of oval macrocytosis on blood film and megablastic bone marrow be treated with vitamin B12 injections in settings where vitamin B12 serum level assays are not easily available.

Adolescent↗
PubMed1987

Bilateral cerebral occipital calcifications and migraine-like headache.

Computed tomography scanning in two young patients with recurrent, pulsating, migraine-like headache showed parieto-occipital calcifications. One patient presented with an atypical form of the Sturge-Weber syndrome, and the other with celiac disease and folic acid deficiency. The clinical features were analyzed and compared with those in other cases reported in the recent literature which have shown bioccipital calcifications but no cutaneous angiomas, sometimes associated with visual and/or intelligence deficit and epilepsy. Finally, the possible connection between cerebral calcifications and headache is discussed.

Adolescent↗
PubMed1999

[Folic acid].

One-carbon derivatives of tetrahydrofolate, the coenzyme form of the vitamin folic acid, play a key role in DNA synthesis and cell replication, through their involvement in the biosynthesis of purine nucleotides and the amino acids. Although the most conspicuous symptom of folic acid deficiency is pernicius anemia, it has been observed that the lack of folate intake during the pregnancy induce the incidence of neural tube defects such as apina bifida. Recently, it has been reported that clinical progression of coronary heart disease and cerebral peripheral vascular disease occurred at a high rate in hyperhomocysteinemia with low folate content in plasma. Consequently, the nutritional importance of folate has been increasingly recognized.

Female↗
PubMed2001

[Coeliac disease and problems associated with reproduction].

Coeliac patients taking a normal diet have a shortened reproductive period with delayed menarche and early menopause. Many studies have shown that coeliac women are susceptible to reproductive difficulties such as infertility and miscarriages. The disease is also associated with low birth weight in babies and short duration of breast feeding. Folic acid deficiency is present in the majority of patients with untreated disease and it might be a maternal risk factor for neural tube defects and orofacial clefts. Coeliac men may have reversible infertility, and as in women, if gastrointestinal symptoms are mild or absent the diagnosis may be missed. It is important to make diagnosis because the giving of gluten free diet may result in conception and favourable outcome of pregnancy.

Abnormalities, Multiple↗