SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Subacute combined degeneration of the cord which occurred as a result of dietary deficiency of folic acid in a patient with a psychotic illness, is described. A significant improvement in the neurological deficit occurred following treatment with folic acid. It is possible that treatment with folate also contributed to the improvement in the patient's psychiatric illness.
The prevalence of human oesophageal cytological abnormalities was determined by means of brush biopsy capsules in the adult occupants of each of 12 households in a low, an intermediate and a high oesophageal cancer rate area in Transkei during 1985 and 1986. Mild cellular changes (folic acid deficiency, atypia and mild dysplasia) as well as advanced changes (dysplasia and cancer) occurred more frequently in the occupants of households in high than in intermediate and low oesophageal cancer rate areas. The prevalence of fungi in homegrown maize from the households in each area was determined by plating surface-sterilized kernels on agar. The prevalence of Fusarium moniliforme was significantly higher (P less than 0.01) in maize from cytologically 'affected' households in the high oesophageal cancer rate area than from 'unaffected' households in the low oesophageal cancer rate area during both seasons. These results confirm previous reports on the difference in the prevalence of F. moniliforme in maize from low and high oesophageal cancer rate areas in Transkei. Whereas the previously established correlation was between F. moniliforme and oesophageal cancer rate, the present results provide evidence for an association between this fungus and oesophageal cytological abnormalities in living individuals. These people will be included in further clinical, epidemiological and aetiological studies.
The increase in volume of human erythrocytes during chronic alcoholic intoxication and its decrease after alcoholic deprivation was studied with a multichannel analyzer. When fractions of the population of red cells were separated by differential centrifugation the macrocytosis was found to be uniformly distributed. The presence of macrocytes was not related to changes of plasma osmolality or hyperhydration of red cells. A central origin was evoked, however, the role of the folic acid deficiency could not explain the macrocytosis, the mechanism of which remains to be elucidated.
In a survey, the pharmacological and clinical documentation of metformin is presented and discussed, and the present state of knowledge relating to metformin-associated lactic acidosis is reviewed. The use of metformin in the treatment of diabetes is based on clinical experience over twenty years. It has been well documented that metformin is effective in maturity-onset diabetes both as monotherapy and in combination with a sulphonylurea. An advantage of metformin treatment is the tendency to weight reduction and the absence of significant hypoglycaemia; blood glucose levels are reduced only to normal. The disadvantages are the gastro-intestinal side effects and the potential risk of vitamin B 12 and folic acid deficiency during long-term use. Metformin-associated lactic acidosis is a very rare complication, which has mainly occured in patients with serious renal insufficiency or other contra-indications to the use of metformin. The association between phenformin and lactic acidosis has led to withdrawal of this biguanide in several countries. Metformin differs from phenformin in certain important respects, and the normal use of metformin does not involve the risk of side effects disproportionate to the intended effect. Further experimental studies are required to substantiate pharmacokinetics and metabolic effects of metformin in man.
A review of published research data on the requirement, intake, and signs of deficiency of vitamins and trace elements in old age is presented. It particularly deals with the problem of a general indication for vitamins and trace element supplements - the mean components of geriatric preparations. Special emphasis is laid on the question if these substances exhibit a specific effect on the alterations of physical and psychic capacity typically accompanying the growing old. It could be shown that in several groups of the elderly diminished vitamin levels are common and/or vitamin and trace element intake does not reach daily recommended allowances. But it still remains unclear if these findings have to be considered as disease symptoms.
A case of scleroderma associated with pancytopenia is reported. The Authors point out that the severe haematological defect was not caused by autoimmune mechanisms and/or by iron, B12 or folic acid deficiency but it was related to bone marrow aplasia. The microangiopathy of scleroderma is taken into consideration as a possible factor responsible of the bone marrow failure.
The cytologic changes of pregnancy and the postpartum period are presented. Atypical cells were identified in 12% of smears; the majority of these atypical cells were related to degenerating decidual cells. Cells thought to represent changes due to folic acid deficiency are also described, and the features that help separate decidual cells from other cell types in the genital tract are illustrated. True neoplasia, when present, tended to persist after delivery, and these cells should not be confused with pregnancy-associated atypia.
Explore the source record for details and available documents.
Appropriate nutrition is necessary for optimal growth and development, physical activity, reproduction, lactation, recovery from illness and injury, and maintenance of health throughout the life cycle. A variety of health problems can occur when persons have deficits of essential nutrients or have excessive or inappropriate consumption of some nutrients. While the role of nutrition in health problems is not fully understood, epidemiologic and laboratory studies offer important insights which may help people in making food choices to enhance their prospects of attaining or maintaining health. Current data indicate an inappropriate nutritional status for a substantial proportion of the American public. For example, for people aged 20 to 74 about 14 percent of men and 24 percent of women are classified as obese. The rates are significantly higher for women regardless of their economic status. Iron and folic acid deficiencies are common among pregnant or lactating women. It has been estimated that between 10 to 15 percent of infants and children among migratory workers and certain rural poor populations suffer growth retardation due to dietary inadequacies. And the average daily sodium ingestion is substantially higher for the U.S. population generally than the recommended intake levels. But some progress has been made over the last decade. Studies indicate that people have begun to consume less total fat, saturated fat, and cholesterol. Prevalence of breast feeding has increased to a point where it is the mode of feeding for 45 percent of newborns in the country. And a number of recent surveys indicate that more people are interested in nutrition, are more aware of the actions they can take to maintain health through their daily eating patterns, and have initiated changes in their nutritional practices.
Anaemias with multivariate pathogenesis are frequently observed in chronic liver diseases. Among our patients 44.4 per cent (132 of 297) had an anaemia. The hepatogenic anaemia which appeared most frequently in patients with liver cirrhosis and carcinoma of the liver was in most cases normochromic (75 per cent), at a small proportion hypochromic (17.4 per cent) and rarely hyperchromic (7.6 per cent). Initial phases of an anaemia were more frequently registered by means of the counting of erythrocytes than by means of the determination of haemoglobin, which is to be traced back to the frequently existing volume macrocytosis. Leptomacrocytes, target cells and acanthocytes are observed as further forms of macrocytes in liver diseases. Among the possible individual factors the more frequently appearing latent and more rarely existing manifest haemolysis prevailed in 82 per cent of the examined patients. A hypersplenism, however, was present only in 24 per cent of the patients, vitamin B12 and folic acid deficiency as well as signs of the ineffective erythropoiesis relatively more infrequently occurred. Additional occult haemorrhages or an increase of the plasma volume may lead to an anaemia in latent haemolysis. As to the diagnosis a basis programme and an enlarged programme are reported on. The therapy has to take into consideration the treatment of the basic disease and the deficiency conditions or disturbances established.
In a survey of quantitative and qualitative changes of blood and blood-forming cell systems by big consumption of alcohol is informed about the frequency of such lesions and the importance of additional substances of alcohol, particularly of the fusel oils with their cancerogenic, mutagenic, hepato- and haemototoxic effects. The alcohol-conditioned lesions of the erythrocytopoiesis with disturbances of maturation by deficiency of folic acid under formation of a megaloblastosis, the alcoholinduced disturbances of the iron metabolism with increase of the sideroblasts as well as the formation of vacuoles in the cytoplasm of the proerythroblasts are discussed. In this connection the symptomatic anaemias, caused by alcoholic liver lesion and its sequelae as well as by ulcerous haemorrhage, particularly also of Zieve's syndrome, are discussed. Functional disturbances of the granulocytes and granulocytopenias are to be brought into connection with the particular susceptibility to infections of patients suffering from alcoholism. Functional disturbances of the thrombocytes and thrombocytopenias, to be sure, rarely lead to a haemorrhagic diathesis, deserve, however, more consideration as possible causing factors in apoplexias under big consumption of alcohol. On principle the direct alcohol-toxic (at least ethanol-toxic) defects of haemotopoiesis are reversible for a short time.
Explore the source record for details and available documents.
OBJECTIVE: To analyse 48 urinary diversions in an oncological patient population. DESIGN: Retrospective study. SETTING: The Dutch cancer institute 'Nederlands Kanker Instituut/Antoni van Leeuwenhoek Ziekenhuis' in Amsterdam, the Netherlands. METHOD: The medical records of all patients who had a urinary diversion in the period 1989-1993 were analysed for type of diversion, indication for this specific type and postoperative complications. RESULTS: In 48 patients (24 women and 24 men with a mean age of 62.1 years) a urinary diversion was constructed because of cystectomy for bladder cancer (n = 27), cystectomy in total pelvic exenteration (13), total urinary incontinence following radiotherapy (5), urethral cancer (1) or local palliation (2). Twenty-one diversions according to Bricker, 25 continent reservoirs according to Rowland and (or) neo-bladders, I ureterosigmoidostomy and I continent access to the bladder (Mitrofanoff procedure) were done. The standard diversion according to Bricker was preferred in the following circumstances: extensive intestinal resections (also previous ones), older age, fear of incontinence or no need for continent diversion. Specific problems of the new diversion techniques were difficulties of patients with catheterising the reservoir and folic acid deficiency. All other postoperative problems were related to the extensiveness of the primary oncological procedure rather than to the diversion technique. CONCLUSION: Apart from a few contraindications such as shortage of intestine, tumour growth into the urethra and patients' inability or unwillingness to catheterize themselves, there are no objections to the new diversion techniques (continent reservoir/neo-bladder). Patients being considered for urinary diversion ought to be informed about these new techniques.
Several recent reports have described convulsions in patients with celiac disease, and in some, folic acid deficiency and brain calcifications. A 40-year-old woman with celiac disease, hypocalcemia and generalized tonic-clonic seizures is reported. Hypocalcemia was corrected and convulsions disappeared, but the EEG showed persistent occipital epileptiform activity. Patients with celiac disease and hypocalcemia due to malabsorption are particularly at increased risk for convulsions. Therefore, even a mild degree of hypocalcemia in these patients should be corrected as soon as possible.
A mitochondrial DNA study of seven hydatidiform moles and seven full term placentas as controls was carried out to determine the role played by mitochondrial DNA as the only maternal genome participating in the pathogenesis of these trophoblastic growths. Mitochondrial DNA was digested by restriction enzymes Eco R1 and Hind III, processed by electrophoresis and stained by ethidium bromide. Molar mitochondrial DNA showed two restriction bands at 9416 and 2322 kbs with Eco R1 and one band at 2322 kbs with Hind III, whereas the controls showed three bands of 9416, 4361 and 2322 kbs with Eco 1, and two bands at 4361 and 2322 kbs with Hind III. The results were interpreted as a DNA alteration consistent with a mutation at level of tARN genes, initiating the reading of gen ND2 of Complex I, NADH dehydrogenase and affecting Complex CO III that transcribe cytochrome c and oxidoreductase genes. The alterations are considered as mutations probably resulted from folic acid deficiency at threshold levels during nuclear and mitochondrial DNA synthesis in oogenesis and meiosis that renders anucleated ova (cytoplasts), fertilized, and further accelerated development of a zygote bearing an entire androgenic genome.
The clinicohaematological findings of acute state (Group A, 30 patients) and chronic state (Group B, 34 patients) of falciparum malaria in paediatric patients are compared. The children with chronic falciparum malaria were apyrexic and presented with features of moderate to severe anaemia with hepato-splenomegaly. Greater severity of anaemia and haemolysis, higher incidence and severity of neutropenia, atypical lymphocytosis, monocytosis and thrombocytopenia were observed in patients with chronic falciparum malaria as compared to patients with acute falciparum malaria despite lesser degree of parasitaemia in the former as compared to the latter. While mechanical destruction of parasitised RBC's, ineffective and dysplastic erythropoiesis either due to unmasking of border line dierty folic acid deficiency or otherwise, transient hypoplasia of bone marrow, impaired utilization of iron and immune destruction of RBCs with hypersplenism may be the mechanisms for anaemia, transient hypoplasia of bone marrow and hypersplenism may be the factors responsible for thrombocytopenia and neutropenia.
Gingival hyperplasia is a common disorder associated with phenytoin and cyclosporine therapy. However, induction of this condition by calcium channel blockers is less well known. Inflammation of the gingival tissue from bacterial plaque and the subsequent development of gingival crevicular fluid may allow sequestration of the calcium channel blocker, thus predisposing the tissue to a localized toxic effect and the development of gingival hyperplasia. Calcium channel blockers have cellular effects similar to those of phenytoin and cyclosporine, including the production of a localized folic acid deficiency. All of the available calcium channel blockers have been reported to cause gingival hyperplasia. Treatment options include meticulous plaque control, and in severe cases, gingivectomy. Gingival hyperplasia can be prevented with meticulous plaque control or avoidance of the offending medication.