Nutritional deficiencies and the prevalence of syndrome X in South Asians.
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Asia↗
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Results for “AVITAMINOSIS”
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Nutrition and cystic fibrosis.
Cystic fibrosis is commonly associated with energy deficiency in children and adults. Chronic undernutrition will lead to failure to thrive, wasting, and stunting of linear growth; nutrition and survival are intimately related in cystic fibrosis. These problems can simply be considered as energy imbalance, and management centers on restoration of energy balance. Specific nutrient deficiencies, such as fat soluble vitamins, are common in cystic fibrosis. Recent work has highlighted problems with bone density and also the prevalence of vitamin K deficiency. Management of nutritional problems can be complex, and injudicious treatment can further worsen the situation, as the relationship between high daily doses of pancreatic enzymes and the development of fibrosing colonopathy illustrates.
Adolescent↗
Monitoring and complications of parenteral nutrition.
A knowledge of the complications of parenteral nutrition is inherent in the design of any monitoring system. In the initial stages of therapy, the complications are usually of electrolyte imbalance. It must also be appreciated that the provision of nutrition to severely malnourished patients will expose underlying deficiencies, particularly of phosphates and trace elements. In long-term parenteral nutrition, the complications can be broadly divided into those associated with the line and metabolic complications. The line complications include: line blockage, sepsis, and pulmonary embolism. The most important metabolic complication is undoubtedly liver cholestasis, which may be associated with recurrent episodes of sepsis. Any department undertaking long-term parenteral nutrition should have an active nutrition team to avoid complications and audit outcome.
Avitaminosis↗
Aging and the immune system: the role of micronutrient nutrition.
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Adult↗
Current international literature citation--nutrition.
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Alcoholism↗
Malnutrition associated with HIV/AIDS. Part One: Definition and scope, epidemiology, and pathophysiology.
A documented association exists between nutritional status and immunologic function, development, and outcome of infectious processes, and treatment-related toxicity and vital organ function. In persons with AIDS, nutritional deficits precipitate a cycle that results in a downward spiral of weight lost, malabsorption, diarrhea, anorexia, body image disturbance, and increased risk for morbidity and mortality. This article presents an overview of the malnutrition in HIV/AIDS patients. It critiques the current Centers for Disease Control's definitions of wasting syndrome, describes the incidence of weight loss, delineates the implications of untreated malnutrition, and traces the etiology of weight loss and contributing factors. This article serves as an introduction to HIV/AIDS related malnutrition. A subsequent article will review nursing implications and clinical management programs.
Acquired Immunodeficiency Syndrome↗
Topical and systemic therapy for recurrent aphthous stomatitis.
The cause of recurrent aphthous ulcers (RAU), the lesions of recurrent aphthous stomatitis, is incompletely understood but appears to involve immune system dysfunction. Treatment options include no treatment, treatment of associated systemic diseases or conditions (eg, celiac sprue, vitamin deficiencies), systemic medications, topical medications, conversion of the aphthous ulcer to a wound, and palliative treatments. The most effective treatments (systemic or topical corticosteroids, thalidomide) involve agents that suppress or modulate immune system function. In general, topical agents are preferred because they have fewer associated side effects; however, inability to obtain adequate contact time may limit their effectiveness. Adjunct pain control is sometimes necessary, either with pain medications or with adherent agents that coat the ulcers.
Adjuvants, Immunologic↗
Management of osteoporosis, fat-soluble vitamin deficiencies, and hyperlipidemia in primary biliary cirrhosis.
Osteoporosis is several times more common in patients with PBC compared with the general population. Maintaining adequate intake of calcium and vitamin D is important for prevention of bone loss. The use of bisphosphonates or vitamin K to improve bone mineral density in osteopenic patients seems promising and needs to be further evaluated. Patients with PBC may develop fat-soluble vitamin deficiencies, especially vitamins A and D; serum levels should be investigated in patients considered at risk with the aim of recommending appropriate replacement therapy. Finally, hyperlipidemia in PBC does not seem to be associated with an increased risk of atherogenesis. New therapies in this patient population are currently under investigation.
Avitaminosis↗
Lipids and lipid-activated vitamins in chronic cholestatic diseases.
Primary biliary cirrhosis, primary sclerosing cholangitis and autoimmune cholangiopathy are cholestatic liver diseases of unknown cause. Destruction of small to medium bile ducts (in primary biliary cirrhosis and autoimmune cholangiopathy) and large bile ducts (in primary sclerosing cholangitis) leads to progressive cholestasis, liver failure and end-stage liver disease. A variety of abnormalities in lipid metabolism have been described in primary biliary cirrhosis, and range from alterations in serum lipid levels and lipoprotein subsets to deranged metabolism of cholesterol. Progressive cholestasis and, consequently, decreased small intestinal bile acid concentrations in these cholestatic liver disease can also lead to impaired absorption of fats and fat-soluble vitamins, resulting in steatorrhea and deficiencies in vitamins A, D, E, and K. This article focuses on abnormalities in lipid metabolism in primary biliary cirrhosis and primary sclerosing cholangitis, and on lipid-activated vitamin deficiencies in these disorders.
Avitaminosis↗
Fat-soluble vitamin deficiency in pregnancy: a case report and review of abetalipoproteinemia.
BACKGROUND: Abetalipoproteinemia (ABL) is a metabolic disorder resulting in poor absorption of fat-soluble vitamins. CASE: Two pregnancies in a woman with ABL are reported, contrasting outcomes with subtherapeutic and normal vitamin levels. CONCLUSION: Fat-soluble vitamin levels in pregnancy are critical for many aspects of fetal development. This report details a congenital ophthalmologic finding that may be associated with vitamin A deficiency.
Abetalipoproteinemia↗
Micronutrients and the pathogenesis of human immunodeficiency virus infection.
Micronutrient deficiencies may be common during human immunodeficiency virus (HIV) infection. Insufficient dietary intake, malabsorption, diarrhoea, and impaired storage and altered metabolism of micronutrients can contribute to the development of micronutrient deficiencies. Low plasma or serum levels of vitamins A, E, B6, B12 and C, carotenoids, Se, and Zn are common in many HIV-infected populations. Micronutrient deficiencies may contribute to the pathogenesis of HIV infection through increased oxidative stress and compromised immunity. Low levels or intakes of micronutrients such as vitamins A, E, B6 and B12, Zn and Se have been associated with adverse clinical outcomes during HIV infection, and new studies are emerging which suggest that micronutrient supplementation may help reduce morbidity and mortality during HIV infection.
Avitaminosis↗
Micronutrients in the severely-injured patient.
The trace element and vitamin requirements of severely-ill injured patients depend on a complex interaction of the status of the patient at the time of admission, ongoing losses and the potential benefit of supplying large amounts of individual micronutrients. Characteristic clinical deficiency states are now uncommon, but subclinical deficiency is of growing concern. The main effects of subclinical deficiency are: (1) an altered balance of reactive oxygen species and antioxidants, leading to oxidative damage of polyunsaturated fatty acids and nucleic acids, and possibly to increased activation of the transcription factor nuclear factor-kappaB, with increased production of pro-inflammatory cytokines: (2) impaired immune function with increased likelihood of infectious complications. Laboratory tests to optimize intake in such critically-ill patients lack sensitivity and specificity, this situation being made worse as a result of the acute-phase response. Recent studies have indicated the clinical benefit of providing large amounts of certain micronutrients in burned and head-injured patients. Further clinical studies are now required to define optimal levels of provision in different disease states, with a particular emphasis on markers of tissue function and clinical outcome.
Avitaminosis↗
Dietary intake and clinical, anthropometric and biochemical indices of malnutrition in elderly demented patients and non-demented subjects.
Anthropometric and biochemical indices of nutritional status and weighed dietary intake have been studied in hospitalized patients with senile dementia, demented patients living in the community and age-matched control subjects who were not cognitively impaired. Demented patients were lighter than control subjects, and had a lower body mass index, skinfold thickness, mid-arm circumference and arm muscle bulk. The hospitalized patients were more seriously affected than those living in the community, and body weight was significantly negatively correlated with duration of hospitalization. Over a 6-month period the hospitalized patients showed a further weight loss, while those living in the community did not. Both groups of demented patients had higher intakes of energy, protein, vitamins and minerals than the control subjects. The diet of the hospitalized patients was slightly, but not significantly, superior to that of the patients living in the community. Biochemical evidence of specific vitamin inadequacy was equally prevalent in all three groups of subjects, and there were no significant correlations between the degree of cognitive impairment or behavioural disorder and any of the indices of nutritional state. Clinical signs suggestive of malnutrition were not correlated with either biochemical evidence of deficiency or cognitive impairment and behavioural disturbance.
Aged↗
Neurophysiological correlates of senile dementia. I. Motor and sensory nerve conduction velocity.
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Acceleration↗
Metabolic and endocrinological causes of dementia.
Deficiencies of vitamins B12, B3 and folate, abnormalities of cortisol metabolism, Wilson's disease, renal and hepatic failure, chronic obstructive pulmonary disease, hypo- and hypernatremia, thyroid and parathyroid dysfunction, hyper- and hypoglycemia and Marchiafava-Bignani disease are metabolic and endocrinological abnormalities that may be associated with cognitive impairment. In some cases these abnormalities may be causative of impaired cognition and in other situations merely associated with cognitive impairment. The existence of these conditions provides some justification for routine investigations commonly performed on patients presenting with possible early dementia.
Avitaminosis↗
The role of vitamins in the prevention and control of anaemia.
OBJECTIVE: While iron deficiency is regarded as the major cause of nutritional anaemia, changes in vitamins A, B12, C and E, folic acid and riboflavin status have also been linked to its development and control. This paper provides a systematic review of vitamin supplementation trials relating to the control of nutritional anaemia. METHODS: A MEDLINE search was used to find reports of vitamin supplementation trials that reported changes in anaemia or iron status. RESULTS: Vitamin A can improve haematological indicators and enhance the efficacy of iron supplementation. Both folate and vitamin B12 can cure and prevent megaloblastic anaemia. Riboflavin enhances the haematological response to iron, and its deficiency may account for a significant proportion of anaemia in many populations. Vitamin C enhances the absorption of dietary iron, although population-based data showing its efficacy in reducing anaemia or iron deficiency are lacking. Vitamin E supplementation given to preterm infants has not reduced the severity of the anaemia of prematurity. Vitamin B6 effectively treats sideroblastic anaemia. Multivitamin supplementation may raise haemoglobin (Hb) concentration, but few studies have isolated the effect of multivitamins from iron on haematological status. CONCLUSIONS: In general, the public health impact of vitamin supplementation in controlling anaemia is not clear. Neither are the complex interactions involving multiple vitamins in haematopoiesis sufficiently understood to explain the observed variability in haematological responses to vitamins by age, population, vitamin mixture and dosages. Further research is needed to understand the roles of individual and combined vitamin deficiencies on anaemia to design appropriate micronutrient interventions to prevent anaemia.
Anemia↗
Studies on the nutritional status of children aged 0-5 years in a drought-affected desert area of western Rajasthan, India.
OBJECTIVE: The present study was undertaken to assess the impact of drought on the nutritional status of pre-school children aged 0-5 years from a rural population in a desert area facing drought conditions very frequently. DESIGN: The sampling design for assessment was the three-stage sampling technique. SETTING: The study was carried out in 24 villages belonging to six tehsils (sub-units of district) of Jodhpur District, a drought-affected desert district of western Rajasthan, during a drought in 2003. SUBJECTS: A total of 914 children were examined at household level, with nutritional status assessed by anthropometry, dietary intake and clinical signs of nutritional deficiency. RESULTS: The results revealed growth retardation. Stunting (malnutrition of long duration) was observed in 53% of children and underweight in 60%. Wasting, an indicator of short-duration malnutrition, was present in 28% of children. The extent of malnutrition was significantly higher in girls than boys (P<0.05). Vitamin A and B complex deficiencies were found in 0.7 and 3.0% of children, respectively. Prevalence of marasmus (protein-energy malnutrition, PEM) was 1.7% (2.3% in boys and 1.1% in girls). Overall deficits in mean energy and protein intakes were very high (76 and 54%, respectively). Comparison of the present drought results with earlier studies in desert normal and desert drought conditions showed higher prevalence of PEM and higher dietary energy and protein deficiencies. CONCLUSIONS: The prevalence of wasting was high, greater than the cut-off point of 15% stated by the World Health Organization to indicate that the severity of malnutrition is critical. PEM, vitamin A and B complex deficiencies and anaemia, along with dietary deficits of energy and protein, were observed to be higher than in non-desert areas. This may be due to the harsh environmental conditions in desert areas where drought occurs quite frequently and adversely affects the economy, largely by eroding the coping capacity and economic potential of the people as a result of heavy livestock losses and reduced harvests, leading to increased poverty and poor food intake of the inhabitants. Due to inadequate consumption of daily food the children were suffering from wasting and PEM. Efforts should be made to incorporate measures, such as ensuring the supply of adequate energy and protein to all age groups and especially pre-school children, into ongoing nutrition programmes in order to improve the food security of local inhabitants in this area.
Avitaminosis↗
Epidemiological survey of vitamin deficiencies in older Thai adults: implications for national policy planning.
OBJECTIVE: To examine the prevalence and risk factors of vitamin deficiencies among older Thai adults. METHODS: The cross-sectional study was conducted in four rural communities, one from each of the four main regions of Thailand. In total, 2336 subjects aged 60 years and over were recruited. Anthropometric variables, demographic data, blood glucose and lipid profile, albumin, globulin and blood levels of vitamin A, beta-carotene, folic acid, vitamin B12, vitamin C, vitamin E and vitamin B1 were all measured. RESULTS: The prevalence of vitamin deficiencies was 0.6% for vitamin B12, 6.1% for vitamin A, 9.9% for vitamin C, 30.1% for vitamin B1, 38.8% for erythrocyte folate, 55.5% for vitamin E and 83.0% for beta-carotene. Male gender was a common risk factor for at least three vitamin deficiencies, i.e. beta-carotene, folate and vitamin E. Being a manual worker was a common risk factor of beta-carotene and vitamin B1 deficiency. Poor income was found as a risk factor only in erythrocyte folate deficiency while increasing age was a significant factor only in vitamin C deficiency. CONCLUSION: The prevalence of vitamin deficiencies among older Thai people was quite different from that found in Western countries, reflecting different socio-economic backgrounds. Vitamin deficiency was not only from poor food intake but also from the dietary habit of monotonous food consumption in older people. Some common associated factors of atherosclerosis were also significantly related to folate and vitamin E deficiencies.
Aged↗